TY - JOUR
T1 - Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure Panel Survey
AU - Lindly, Olivia J.
AU - Zuckerman, Katharine E.
AU - Mistry, Kamila B.
N1 - Funding Information:
Joint Acknowledgment/Disclosure Statement: This project was supported by the Agency for Healthcare Research and Quality Junior Summer Fellows Program. The views expressed in this article are those of the authors, and no official endorsement by the U.S. Department of Health and Human Services or the Agency for Healthcare Research and Quality is intended or should be inferred. We thank Drs. Sheryl Thorburn, Adam Branscum, and Kari-Lyn Sakuma for their constructive feedback on an initial draft of the manuscript, as well as Drs. Ernest Moy and Denise Dougherty for their initial involvement in the study's conceptualization. We also thank Dr. Barbara Schone for her thoughtful feedback on a revised version of this manuscript. Disclosures: None. Disclaimers: None.
Publisher Copyright:
© Health Research and Educational Trust
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objectives: 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. Data Source: The Medical Expenditure Panel Survey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population. Study Design: 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. Data Collection/Extraction Methods: We combined four MEPS-HC longitudinal files from 2007 to 2011. Principal Findings: 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. Conclusions: 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.
AB - Objectives: 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. Data Source: The Medical Expenditure Panel Survey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population. Study Design: 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. Data Collection/Extraction Methods: We combined four MEPS-HC longitudinal files from 2007 to 2011. Principal Findings: 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. Conclusions: 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.
KW - Family-centered care
KW - health services utilization
KW - medical expenditures
KW - shared decision making
KW - unmet health care needs
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U2 - 10.1111/1475-6773.12488
DO - 10.1111/1475-6773.12488
M3 - Article
C2 - 27072197
AN - SCOPUS:84963657341
SN - 0017-9124
VL - 52
SP - 313
EP - 345
JO - Health Services Research
JF - Health Services Research
IS - 1
ER -