Authors: LaQuanta P Smalley Mary Kay Kenney Diana Denboba Bonnie Strickland
Publish Date: 2013/09/20
Volume: 18, Issue: 6, Pages: 1316-1327
Abstract
The Maternal and Child Health Bureau recently revised its measure of familyprovider shared decisionmaking SDM to better align with parents’ views and the intent of SDM We sought to assess achievements in meeting the revised measure examine sociodemographic/health correlates and determine the relationships between SDM and access to quality health care We analyzed data for 40242 children with special health care needs CSHCN from the 2009–2010 National Survey of CSHCN and assessed the prevalence of SDM and association with other US CSHCN sociodemographic/health characteristics using bivariate and multivariate methods Logistic regression was used to determine associations between SDM and having a medical home and preventive medical/dental visits Approximately 70 of families of CSHCN perceived themselves as shared decisionmakers in their child’s care Families of CSHCN with greater functional limitations had twice the odds of lacking SDM than those never affected Disparities in attainment rates were noted for families with low versus high income 61 vs 77 less versus more than high school education 59 vs 73 privately insured versus uninsured 76 vs 57 and minority versus white race 63 vs 74 CSHCN with medical homes had 6 times greater odds of perceived SDM and as much as one and a half times the odds of receiving preventive care than CSHCN without a medical home Major differences in family SDM perceptions are associated with having a medical home particularly when characterized by familycentered care Populations of concern are those with more functionally limited children and increased socioeconomic challengesThe views expressed in this publication are solely the opinions of the authors and do not necessarily reflect the official policies of the US Department of Health and Human Services or the Health Resources and Services Administration nor does mention of the department or agency names imply endorsement by the US Government
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