Family-Centered Care Measurement and Associations With Unmet Health Care Need Among US Children

Olivia J. Lindly, G. John Geldhof, Alan C. Acock, Kari Lyn K Sakuma, Katharine Zuckerman, Sheryl Thorburn

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Family-centered care (FCC), including shared decision making (SDM), has become increasingly emphasized in pediatric health care delivery. Past studies using national surveys have used different FCC measurement approaches without determining their validity. We, therefore, sought to develop an FCC measurement model with Medical Expenditure Panel Survey (MEPS) items previously used to assess FCC or SDM; and to determine temporal associations of FCC with unmet health care need. Methods: Four longitudinal MEPS data files (2007-2011) were combined. The study sample included 15,764 US children aged 0 to 17 years. Eight items assessed FCC, and 5 items assessed unmet health care need. We performed exploratory factor analyses to develop an FCC measurement model and fit a cross-lagged structural equation model to determine temporal associations between FCC and unmet health care need. Results: Results supported a 2-factor FCC model including family-provider communication and SDM. The family-provider communication factor was indicated by items reflecting general communication between the child's doctor and family. The SDM factor was indicated by items reflecting decision-making about the child's health care. Adjusted cross-lagged structural equation model results showed family-provider communication and SDM were associated with a reduced likelihood of unmet health care need the following year. Unmet health care need was not significantly associated with family-provider communication or SDM the subsequent year. Conclusions: Study results support differentiating between family-provider communication and SDM as interrelated aspects of FCC in future pediatric health care quality measurement and improvement. Family-provider communication and SDM may reduce the likelihood of unmet health care need the following year among US children.

Original languageEnglish (US)
JournalAcademic Pediatrics
DOIs
StateAccepted/In press - Jun 20 2016

Fingerprint

Delivery of Health Care
Decision Making
Communication
Structural Models
Health Expenditures
Pediatrics
Information Storage and Retrieval
Child Care
Quality Improvement
Statistical Factor Analysis

Keywords

  • Family-centered care
  • Pediatric health care quality measurement
  • Shared decision making
  • Structural equation modeling
  • Unmet health care need

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Family-Centered Care Measurement and Associations With Unmet Health Care Need Among US Children. / Lindly, Olivia J.; Geldhof, G. John; Acock, Alan C.; Sakuma, Kari Lyn K; Zuckerman, Katharine; Thorburn, Sheryl.

In: Academic Pediatrics, 20.06.2016.

Research output: Contribution to journalArticle

Lindly, Olivia J. ; Geldhof, G. John ; Acock, Alan C. ; Sakuma, Kari Lyn K ; Zuckerman, Katharine ; Thorburn, Sheryl. / Family-Centered Care Measurement and Associations With Unmet Health Care Need Among US Children. In: Academic Pediatrics. 2016.
@article{a9832a2480144d40b751efdc15141ae6,
title = "Family-Centered Care Measurement and Associations With Unmet Health Care Need Among US Children",
abstract = "Objective: Family-centered care (FCC), including shared decision making (SDM), has become increasingly emphasized in pediatric health care delivery. Past studies using national surveys have used different FCC measurement approaches without determining their validity. We, therefore, sought to develop an FCC measurement model with Medical Expenditure Panel Survey (MEPS) items previously used to assess FCC or SDM; and to determine temporal associations of FCC with unmet health care need. Methods: Four longitudinal MEPS data files (2007-2011) were combined. The study sample included 15,764 US children aged 0 to 17 years. Eight items assessed FCC, and 5 items assessed unmet health care need. We performed exploratory factor analyses to develop an FCC measurement model and fit a cross-lagged structural equation model to determine temporal associations between FCC and unmet health care need. Results: Results supported a 2-factor FCC model including family-provider communication and SDM. The family-provider communication factor was indicated by items reflecting general communication between the child's doctor and family. The SDM factor was indicated by items reflecting decision-making about the child's health care. Adjusted cross-lagged structural equation model results showed family-provider communication and SDM were associated with a reduced likelihood of unmet health care need the following year. Unmet health care need was not significantly associated with family-provider communication or SDM the subsequent year. Conclusions: Study results support differentiating between family-provider communication and SDM as interrelated aspects of FCC in future pediatric health care quality measurement and improvement. Family-provider communication and SDM may reduce the likelihood of unmet health care need the following year among US children.",
keywords = "Family-centered care, Pediatric health care quality measurement, Shared decision making, Structural equation modeling, Unmet health care need",
author = "Lindly, {Olivia J.} and Geldhof, {G. John} and Acock, {Alan C.} and Sakuma, {Kari Lyn K} and Katharine Zuckerman and Sheryl Thorburn",
year = "2016",
month = "6",
day = "20",
doi = "10.1016/j.acap.2016.10.018",
language = "English (US)",
journal = "Academic Pediatrics",
issn = "1876-2859",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Family-Centered Care Measurement and Associations With Unmet Health Care Need Among US Children

AU - Lindly, Olivia J.

AU - Geldhof, G. John

AU - Acock, Alan C.

AU - Sakuma, Kari Lyn K

AU - Zuckerman, Katharine

AU - Thorburn, Sheryl

PY - 2016/6/20

Y1 - 2016/6/20

N2 - Objective: Family-centered care (FCC), including shared decision making (SDM), has become increasingly emphasized in pediatric health care delivery. Past studies using national surveys have used different FCC measurement approaches without determining their validity. We, therefore, sought to develop an FCC measurement model with Medical Expenditure Panel Survey (MEPS) items previously used to assess FCC or SDM; and to determine temporal associations of FCC with unmet health care need. Methods: Four longitudinal MEPS data files (2007-2011) were combined. The study sample included 15,764 US children aged 0 to 17 years. Eight items assessed FCC, and 5 items assessed unmet health care need. We performed exploratory factor analyses to develop an FCC measurement model and fit a cross-lagged structural equation model to determine temporal associations between FCC and unmet health care need. Results: Results supported a 2-factor FCC model including family-provider communication and SDM. The family-provider communication factor was indicated by items reflecting general communication between the child's doctor and family. The SDM factor was indicated by items reflecting decision-making about the child's health care. Adjusted cross-lagged structural equation model results showed family-provider communication and SDM were associated with a reduced likelihood of unmet health care need the following year. Unmet health care need was not significantly associated with family-provider communication or SDM the subsequent year. Conclusions: Study results support differentiating between family-provider communication and SDM as interrelated aspects of FCC in future pediatric health care quality measurement and improvement. Family-provider communication and SDM may reduce the likelihood of unmet health care need the following year among US children.

AB - Objective: Family-centered care (FCC), including shared decision making (SDM), has become increasingly emphasized in pediatric health care delivery. Past studies using national surveys have used different FCC measurement approaches without determining their validity. We, therefore, sought to develop an FCC measurement model with Medical Expenditure Panel Survey (MEPS) items previously used to assess FCC or SDM; and to determine temporal associations of FCC with unmet health care need. Methods: Four longitudinal MEPS data files (2007-2011) were combined. The study sample included 15,764 US children aged 0 to 17 years. Eight items assessed FCC, and 5 items assessed unmet health care need. We performed exploratory factor analyses to develop an FCC measurement model and fit a cross-lagged structural equation model to determine temporal associations between FCC and unmet health care need. Results: Results supported a 2-factor FCC model including family-provider communication and SDM. The family-provider communication factor was indicated by items reflecting general communication between the child's doctor and family. The SDM factor was indicated by items reflecting decision-making about the child's health care. Adjusted cross-lagged structural equation model results showed family-provider communication and SDM were associated with a reduced likelihood of unmet health care need the following year. Unmet health care need was not significantly associated with family-provider communication or SDM the subsequent year. Conclusions: Study results support differentiating between family-provider communication and SDM as interrelated aspects of FCC in future pediatric health care quality measurement and improvement. Family-provider communication and SDM may reduce the likelihood of unmet health care need the following year among US children.

KW - Family-centered care

KW - Pediatric health care quality measurement

KW - Shared decision making

KW - Structural equation modeling

KW - Unmet health care need

UR - http://www.scopus.com/inward/record.url?scp=85016454659&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016454659&partnerID=8YFLogxK

U2 - 10.1016/j.acap.2016.10.018

DO - 10.1016/j.acap.2016.10.018

M3 - Article

JO - Academic Pediatrics

JF - Academic Pediatrics

SN - 1876-2859

ER -