title: Development and Validation of a Method to Identify Children With Social Complexity Risk Factors.
abstract: We sought to develop and validate a method to identify social complexity risk factors (eg, limited English proficiency) using Minnesota state administrative data. A secondary objective was to examine the relationship between social complexity and caregiver-reported need for care coordination.
  
  
  
  A total of 460 caregivers of children with noncomplex chronic conditions enrolled in a Minnesota public health care program were surveyed and administrative data on these caregivers and children were obtained. We validated the administrative measures by examining their concordance with caregiver-reported indicators of social complexity risk factors using tetrachoric correlations. Logistic regression analyses subsequently assessed the association between social complexity risk factors identified using Minnesota's state administrative data and caregiver-reported need for care coordination, adjusting for child demographics.
  
  
  
  Concordance between administrative and caregiver-reported data was moderate to high (correlation range 0.31-0.94, all P values <.01), with only current homelessness (r = -0.01, P = .95) failing to align significantly between the data sources. The presence of any social complexity risk factor was significantly associated with need for care coordination before (unadjusted odds ratio = 1.65; 95% confidence interval, 1.07-2.53) but not after adjusting for child demographic factors (adjusted odds ratio = 1.53; 95% confidence interval, 0.98-2.37).
  
  
  
  Social complexity risk factors may be accurately obtained from state administrative data. The presence of these risk factors may heighten a family's need for care coordination and/or other services for children with chronic illness, even those not considered medically complex.
authors: Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California; sschrager@chla.usc.edu.
authors: Sheree M
authors: SM
authors: Schrager
authors: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Washington;
authors: Kimberly C
authors: KC
authors: Arthur
authors: Minnesota Department of Human Services, St. Paul, Minnesota;
authors: Justine
authors: J
authors: Nelson
authors: Park Nicollet Health Services, Minneapolis, Minnesota;
authors: Anne R
authors: AR
authors: Edwards
authors: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts;
authors: J Michael
authors: JM
authors: Murphy
authors: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; and.
authors: Rita
authors: R
authors: Mangione-Smith
authors: Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California.
authors: Alex Y
authors: AY
authors: Chen
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology; D002648:Child; D002662:Child Health Services; D002669:Child Welfare; D002675:Child, Preschool; D002908:Chronic Disease / Q000628:therapy*; D003266:Continuity of Patient Care; D005260:Female; D019538:Health Care Surveys; D006305:Health Status Indicators; D018453:Homeless Youth; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007802:Language; D016015:Logistic Models; D008297:Male; D008910:Minnesota; D010347:Patient Care Planning; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D035862:Vulnerable Populations