title: Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure Panel Survey.
abstract: To estimate (1) family-centered care (FCC) and shared decision-making (SDM) prevalence, and (2) associations of FCC and SDM (FCC/SDM) with health care outcomes among U.S. children.
  
  
  
  The Medical Expenditure Panel Survey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population.
  
  
  
  Secondary analyses of prospectively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization, medical expenditures, and unmet health care needs in year 2.
  
  
  
  We combined four MEPS-HC longitudinal files from 2007 to 2011.
  
  
  
  FCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent, and it was lower for composites with more stringent scoring approaches. FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2. FCC/SDM, across all year 1 composites, was not associated with health services utilization or medical expenditures in year 2. FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2.
  
  
  
  FCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts.
authors.affiliation: School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR.|Division of General Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Olivia J
authors.initials: OJ
authors.lastname: Lindly
authors.affiliation: Division of General Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Katharine E
authors.initials: KE
authors.lastname: Zuckerman
authors.affiliation: Agency for Healthcare Research and Quality, Office of Extramural Research, Education, and Priority Populations, Rockville, MD.
authors.forename: Kamila B
authors.initials: KB
authors.lastname: Mistry
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000379:methods / Q000458:organization & administration; D018802:Patient-Centered Care / Q000191:economics / Q000379:methods; D010372:Pediatrics / Q000191:economics / Q000379:methods; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States
keywords: Family-centered care; health services utilization; medical expenditures; shared decision making; unmet health care needs