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Survey Items: K4Q01; K4Q02R; K4Q04; K4Q22; K4Q24; K5Q10; K5Q11; K5Q20; K5Q21; K5Q22; K5Q30; K5Q31; K5Q32; K5Q40; K5Q41; K5Q42; K5Q43; K5Q44
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: One minor revision was undertaken between the 2007 and 2011/12 NSCH. An item assessing whether or not the child or child's family required an interpreter and whether or not the interpreter was usually or always provided was dropped from the survey due to low numbers endorsing this items, particularly outside the state of California.
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. 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. For the 2007 NSCH, presence of a medical home is measured by a composite based on five component variables constructed from a total of 19 survey items. These component indicators are: - Indicator 4.9: Personal doctor or nurse - pdn - Indicator 4.9a: Usual source for sick and well care - usual - Indicator 4.9b: Family-centered care - famcent - Indicator 4.9c: Problems getting needed referrals - norefprob - Indicator 4.9d: Effective Care Coordination when needed - carecoor. 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. Any children who needed referrals or care coordination must also meet criteria for those components in order to qualify as having a medical home. Further information about Medical Home concept and measurement is available on the Data Resource Center Medical Home portal, and on the AAP Medical Home web page.
Treatment of Unknown Values: Unknown values (responses coded as 'refused', 'don't know', or system missing) are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the data query results table. In nearly every case, the proportion of unknown values is less than 1% and the exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Weighted Est.). Exceptions are noted in the form of a “Data Alert” at the bottom of a results table.
History and Development: The Maternal and Child Health Bureau leads the development of the NSCH survey and indicators, in collaboration with the National Center for Health Statistics (NCHS) and a national technical expert panel. The expert panel includes representatives from other federal agencies, state Title V leaders, family organizations, and child health researchers. Previously validated questions and scales are used when available. Respondents’ cognitive understanding of the survey questions is assessed during the pretest phase and revisions made as required. All final data components are verified by NCHS and DRC/CAHMI staff prior to public release. The samples in 2003 and 2007 were drawn by random digit dial telephone sampling. The 2011/12 survey included the addition of cell phones to the sample. This has implications for the comparability of items between 2007 and 2011/12. More information can be found in the “Learn About the Surveys” section of this website.
C.I. = 95% Confidence Interval. Percentages and population estimates (Pop.Est.) are weighted to represent child population in US.
DATA ALERT: Household poverty level for the 9.3% of households in the sample with unknown values for income, household size, or both, was calculated using single imputation methods. The poverty level estimates and confidence intervals based on single imputed poverty will differ from those calculated using multiple imputations.
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With funding and direction from the Maternal and Child Health Bureau, the National Survey of Children’s Health was conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. CAHMI is responsible for the analyses, interpretations, presentations and conclusions included on this site.
Suggested citation format: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved [mm/dd/yy] from www.childhealthdata.org.