Utilization of Care Coordination Among Children with Special Needs in the 1994 National Health Interview Survey on Disability Phase II
Review TypeNone: Degree-based Submission
Review StatusNot Applicable (See Review Type)
Repository Posting Date2019-05-06T17:50:58Z
Author(s)Kruger, Barbara J.
Author DetailsBarbara J. Kruger, PhD, MPH, RN
Lead Author Sigma AffliationLambda Rho at-Large
Level of EvidenceCross-Sectional
Research ApproachQuantitative Research
CINAHL HeadingsHealth Services Needs and Demand -- In Infancy and Childhood; Case Management; Child, Medically Fragile; Health Services Needs and Demand
Care coordination helps families of children with special needs obtain a variety of services and manage communication among providers. Some families coordinate care themselves, while others receive assistance from professionals. Health care system changes are making these children less visible, and therefore at-risk for not receiving care coordination. A key question is how to identify families who need care coordination. Research about use of care coordination is sparse, and no generalizable method exists to identify which families require coordination. One aim of our study was to explore the differences among child and family factors and the use and need for health and related services between families who do and do not use care coordination. A second aim was to identify the determinants of professional care coordination. Secondary analyses of children, birth to 18 years of age, produced a weighted sample of 7,870,264 children of which 67% used care coordination. Professionals were more frequent providers of coordination compared to families and professionals or families alone. Multivariate logistic regression showed that children who had private insurance, those who used health, support, equipment, or therapy services, and those who used a greater variety of these services were more likely to have coordination. Fair or poor child health status, co-morbidities, family financial stress, and need for services also predicted use of coordination. Children least likely to receive coordination were black, were foreign-born, lived in large families, or lived on the west coast. Multinomial logistic regression showed that highly educated, residentially stable families whose child had private or public insurance, used health services, and had good health status were more likely to have professional coordination. Families with older children, children who were black, or who lived on the west coast were less likely to use professional coordination. Our study suggests that children and families who might need care coordination may not be receiving it, and that racial/ethnic disparities exist. It supports that a focus on the family and social context, as well as the child and medical context, is necessary. Nurses are well-positioned across health and human services systems to influence policy, practice, and research.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3136963; ProQuest document ID: 305181096. The author still retains copyright.
Advisor(s)Kneipp, Shawn M.
Degree GrantorUniversity of Florida
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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