Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure Panel Survey

Olivia J. Lindly, Katharine Zuckerman, Kamila B. Mistry

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalHealth Services Research
DOIs
Publication statusAccepted/In press - 2016

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Keywords

  • Family-centered care
  • Health services utilization
  • Medical expenditures
  • Shared decision making
  • Unmet health care needs

ASJC Scopus subject areas

  • Health Policy

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