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Survey Items: Survey instrument item number for children 0-5 years: C9, C10 (2017), C10, C11 (2018), D1-D4, D7-D12; for children 6-11 years: C7, C8 (2017), C8, C9 (2018), D1-D4, D7-D12; for children 12-17 years: C8, C9 (2017), C9, C10 (2018) D1-D4, D7-D12 Variables in public use data file: K4Q01 in 2017; K4Q01 in 2018; K4Q02_R; K4Q04_R; K5Q40; K5Q41; K5Q42; K5Q43; K5Q44; K5Q10; K5Q11 in 2017; K5Q11 in 2018; K5Q20_R in 2017; K5Q20_R in 2018; K5Q21; K5Q22; K5Q30 in 2018; K5Q30 in 2017; K5Q31_R; K5Q32 in 2017; K5Q32 in 2018
Denominator: Children age 0-17 years
Numerator: Children whose health care does not meet Medical Home criteria; Children whose health care meets Medical Home criteria
Revisions and Changes: Though there were some changes to a few items which are used to score this measure, the overall concept of medical home and how it is measured in the survey did not change; therefore, the results may be compared. The most significant change was applied to the "Problems getting needed referral" subcomponent. In 2017 the item was worded to ask how much of a problem it was to get referrals. The answers were no problem, somewhat of a problem or a big problem. The question was reworded in 2018 to ask how difficult it was to receive a referral, with corresponding response option changes to not difficult, somewhat difficult and very difficult. Because of this change this subcomponent of medical home measure is not comparable across years and is not displayed in the DRC data query. For more information about the changes, click here.
Additional Notes: The American Academy of Pediatrics specifies seven qualities essential to medical home care: accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally effective care. Ideally, medical home care is delivered within the context of a trusting and collaborative relationship between the child’s family and a competent health professional who is familiar with the child and family and the child’s health history. In the 2017-2018 NSCH, the presence of a medical home was measured by a composite measure based on five components constructed from a total of 16 survey items. These components are: - Personal doctor or nurse (Indicator 4.12a: PerDrNs_1718) - Usual source for sick care (Indicator 4.12b: UsualSck_1718) - Family-centered care (Indicator 4.12c: FamCent_1718) - Problems getting needed referrals (Indicator 4.12d: NoRefPrb_1718) (not shown in the 2017 and 2018 NSCH data query due to changes to the item. See Revisions note). - Effective Care Coordination when needed (Indicator 4.12e: CareCoor_1718). To qualify as having a Medical Home, children must meet the criteria for adequate care on the first three components: personal doctor or nurse, usual source for care, and family-centered care. Additionally, any children who needed referrals or care coordination must also meet criteria for those components in order to qualify as having a medical home. Children with a valid, positive response to at least one component and the remainder of the components were missing or legitimately skipped are categorized as having a medical home. The CAHMI developed a medical home manual in 2009. Although there have been some slight changes in the specific items over the years, the general concepts described in the manual are still valid. The manual is available on the CAHMI website.
Treatment of Unknown Values: Missing values may be due to non-response (i.e. a skipped item) or a “don’t know” response. The way these items are handled can vary by measure. For NPMs and NOMs, having missing values for all items in an indicator will lead to the case being given a missing value on the overall measure. For some other measures, if there is a missing value on any of the items, the case will be set to missing. How missing values are handled is documented in the "Additional notes" field above when required. Missing values are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the Interactive Data Query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). To learn about the impact of the missing values on the population count estimates, click here.
History and Development: The Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children's Health (NSCH), and develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children's health, federal and state stakeholders, clinicians and researchers. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents' cognitive understanding of the survey questions was assessed during the pretest phase of the survey redesign (in 2015) and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript "The Design and Implementation of the 2016 National Survey of Children's Health" provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 and 2018 NSCH. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an addressed based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. More information about the survey can be found in the "About the National Survey of Children's Health" section of this website and HRSA's MCHB website.
Indicator 4.12: Did this child receive coordinated, ongoing, comprehensive care within a medical home?
Notes: Click on the Column Header to sort the results by ascending or descending order. To get a detailed explanation of the data HOVER over the text in the table.
Select a Response Category: Care met medical home criteria Care did not meet medical home criteria
Data Source: National Survey of Children’s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/data/national-surveys
Citation: Child and Adolescent Health Measurement Initiative. 2017-2018 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].