Survey Results

Survey Items: Survey instrument item number for children 0-5 years: D7-12; for children 6-11 years: D7-12; for children 12-17 years: D7-12
Variable in public use data file: K5Q20_R; K5Q21; K5Q22; K5Q30; K5Q31_R; K5Q32

Denominator: Children age 0-17 years who needed care coordination

Numerator: Children who received needed coordination; Children who did not receive needed coordination

Revisions and Changes: In 2017, the content of this measure did not change from the 2016 NSCH. In 2017, the skip pattern is changed to no longer instruct respondents to skip the follow-up questions if the response to the question "Does anyone help you arrange or coordinate this child's care among the different doctors or services that this child uses?" is "Did not see more than one health care provider in the past 12 months".
Due to changes in the administration and sampling for the NSCH, results from surveys prior to 2016 are not directly comparable and should not be used to conduct trend analyses. In the 2011/12 NSCH, the this question was asked among children who received more than one type of service: medical, dental, mental health care or received/needed a specialist care that was set in the survey instrument programming (NUMB_SERVICES>1). In the 2016 NSCH, this question was asked among all children who had a health care visit during the past 12 months, and included a response option: "Did not see more than one health care provider in past 12 months". The follow-up questions K5Q21, K5Q22, and K5Q30 were asked if responses to K5Q20_R were "Yes" or "No" (K5Q20_R=1 or K5Q20_R=2) indicating that they saw more than one health care provider.
In the NSCH 2011/12, the composite care coordination measure was considered missing if any component has missing data. In the 2016, the measure is only considered missing if all components are missing.

Additional Notes: This measure is one of the five components of the composite Medical Home measure. All questions used to create the measure were asked among children who had a health care visit in the past 12 months. The effective care coordination measure is constructed by assessing communication between doctors when needed (K5Q22; K5Q30), communication between doctors and schools when needed (K5Q32) (K5Q31_R); and getting needed help coordinating care (K5Q20_R, K5Q21). Children who did not see more than one health care provider (K5Q20_R=3 or legit skip) were coded as not needing care coordination. The denominator of this measure includes only children who needed care coordination. Please see the measure Indicator 4.12e: Effective care coordination for further information on how many children did not need care coordination in the past 12 months. That data will show the percentage of children who received all needed coordination out of all children, even those who did not need care coordination.
The composite care coordination measure is only considered missing if all components are missing. Therefore, 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 received effective care coordination.

Treatment of Unknown Values: Missing values due to non-response or a “don’t know” response are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the 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.). If missing cases are handled in any other way, details can be found in the "Additional notes" section above.

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 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 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.