Survey Results

Survey Items: Over 50 different survey questions are used to construct this measure.

Denominator: Children with special health care needs age 0-17 years

Numerator: Receive care in a well-functioning system; Do not receive care in a well-functioning system

Revisions and Changes: There have been changes in four components of this measures since 2016. Changes could be in the way the item was worded, in the response options provided, or in other areas such as a skip pattern change etc. For additional information see a crosswalk of survey items from 2016 through 2019.
However, overall measure is comparable across years.

Additional Notes: This measure is comprised of five age-relevant measures for children age 0-11 years, and six age-relevant measures for children age 12-17 years. Those five measures for children age 0-11 years include: family feels like they are a partner in their child’s care, child receives care within a medical home, child had a past-year preventive medical and dental visit, child has adequate insurance, and child did not have a time when he/she needed health care that was not received and was not frustrated in receiving health care. For adolescents age 12-17 years, preparation for adult transition is included in addition to these five measures. If a child has at least one valid positive response to any of these measures and the remainder of the components were missing or legitimately skipped, this child was categorized as receiving care in a well-functioning system in the 2018-2019 scoring of this measure. Respondents with "missing" to all items were set to missing. The denominator for this outcome measure is children with special health care needs identified by the standardized CSHCN Screener.

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:
Overview of the Title V Block Grant
The Title V Maternal and Child Health (MCH) Services Block Grant Program is a federal-state partnership to improve the health and well-being of mothers, children (including children with special health care needs) and their families in all 59 states and jurisdictions. The Title V MCH Block Grant Performance Measure Framework enables states to demonstrate the impacts of Title V within a state. The performance measurement system utilizes national data sources, including the NSCH, to track the ultimate outcomes of the program -- National Outcome Measures (NOMs) – and the key metrics of health behavior or health care access and quality -- National Performance Measures (NPMs) -- that influence NOMs. For more information on NPM and NOM content changes, click here. More information about the Title V MCH Block Grant and performance measurement system can be obtained at the MCHB website.
About NSCH
The National Survey of Children’s Health (NSCH), funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB), is designed to provide annual national and state-level information on the health and well-being of children ages 0-17 years in the United States. The U.S. Census Bureau administers the survey, oversees the sampling, and produces a final data set of survey results. HRSA’s Maternal and Child Health Bureau (MCHB) 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. In 2016, the NSCH underwent a significant redesign which combined content from both the NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Further information on that redesign can be found in “The Design and Implementation of the 2016 National Survey of Children’s Health”.
The NSCH is conducted as a household survey, and one child per household is selected to be the subject for the detailed age-specific questionnaire. The respondent to this questionnaire is a parent or guardian who is living in the home and has knowledge of the sampled child. Survey participants complete either web-based or self-administered paper-and-pencil questionnaires. Data from the NSCH is used for scientific research, federal policy and program development, and state-level planning and performance reporting. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, systems of care for CSHCN, family interactions, parental health, school and after-school experiences, and neighborhood characteristics. 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.