Associations of Family-Centered Care with Health Care Outcomes for Children with Special Health Care Needs

• Published in: Maternal and child health journal Vol. 15; no. 6; pp. 794 - 805
• Main Authors: Kuo, Dennis Z., Bird, T. Mac, Tilford, J. Mick
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.08.2011; Springer; Springer Nature B.V
• Subjects: Adolescent; Child; Child Health Services - standards; Child Health Services - statistics & numerical data; Child, Preschool; Children; Children & youth; Childrens health; Collaboration; Disabled Children - statistics & numerical data; Emergency medical care; Emergency medical services; Family Nursing; Gynecology; Health aspects; Health care; Health care delivery; Health care industry; Health planning; Health services; Health Services Needs and Demand - statistics & numerical data; Humans; Immunization; Infant; Infant, Newborn; Maternal & child health; Maternal and Child Health; Medicine; Medicine & Public Health; Out of pocket costs; Pediatrics; Physician-Patient Relations; Polls & surveys; Population Economics; Public Health; Secondary analysis; Sociology; Statistical analysis; Surveys; Treatment Outcome; United States; United States; United States > US; Physician/patient relationship; Unmet needs; Children with special health care needs; Health care outcomes; Family-centered care
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-010-0648-x

The objective of this study is to examine the association of family-centered care (FCC) with specific health care service outcomes for children with special health care needs (CSHCN). The study is a secondary analysis of the 2005–2006 National Survey of Children with Special Health Care Needs. Receipt of FCC was determined by five questions regarding how well health care providers addressed family concerns in the prior 12 months. We measured family burden by reports of delayed health care, unmet need, financial costs, and time devoted to care; health status, by stability of health care needs; and emergency department and outpatient service use. All statistical analyses used propensity score-based matching models to address selection bias. FCC was reported by 65.6% of respondents ( N  = 38,915). FCC was associated with less delayed health care (AOR: 0.56; 95% CI: 0.48, 0.66), fewer unmet service needs (AOR: 0.53; 95% CI: 0.47, 0.60), reduced odds of ≥1 h/week coordinating care (AOR: 0.83; 95% CI: 0.74, 0.93) and reductions in out of pocket costs (AOR: 0.88; 95% CI: 0.80, 0.96). FCC was associated with more stable health care needs (AOR: 1.11; 95% CI: 1.01, 1.21), reduced odds of emergency room visits (AOR: 0.90; 95% CI: 0.82, 0.99) and increased odds of doctor visits (AOR: 1.25; 95% CI: 1.14, 1.37). Our study demonstrates associations of positive health and family outcomes with FCC. Realizing the health care delivery benefits of FCC may require additional encounters to build key elements of trust and partnership.