Association of Family-Centered Care with Improved Anticipatory Guidance Delivery and Reduced Unmet Needs in Child Health Care |
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Authors: | Dennis Z Kuo Kevin D Frick Cynthia S Minkovitz |
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Institution: | (1) Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA;(2) Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;(3) Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;(4) Arkansas Children’s Hospital, Pediatrics/CARE Slot 512-26, 1 Children’s Way, Little Rock, AR 72202, USA |
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Abstract: | Little is known about the association of family-centered care (FCC) with the quality of pediatric primary care. The objectives
were to assess (1) associations between family-centered care (FCC), receipt of anticipatory guidance, and unmet need for health
care; and (2) whether these associations vary for children with special health care needs (CSHCN). The study, a secondary
data analysis of the 2004 Medical Expenditure Panel Survey, used a nationally representative sample of family members of children
0–17 years. We measured receipt of FCC in the last 12 months with a composite score average >3.5 on a 4 point Likert scale
from 4 Consumer Assessment of Healthcare Providers and Systems questions. Outcome measures were six anticipatory guidance
and six unmet health care service needs items. FCC was reported by 69.6% of family members. One-fifth (22.1%) were CSHCN.
Thirty percent of parents reported ≥4 of 6 anticipatory guidance topics discussed and 32.5% reported ≥1 unmet need. FCC was
positively associated with anticipatory guidance for all children (OR = 1.45; 95% CI 1.19, 1.76), but no relation was found
for CSHCN in stratified analyses (OR = 1.01; 95% CI .75, 1.37). FCC was associated with reduced unmet needs (OR = .38; 95%
CI .31, .46), with consistent findings for both non-CSHCN and CSHCN subgroups. Family-centered care is associated with greater
receipt of anticipatory guidance and reduced unmet needs. The association between FCC and anticipatory guidance did not persist
for CSHCN, suggesting the need for enhanced understanding of appropriate anticipatory guidance for this population. |
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