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Survey Items: Over 50 different survey questions are used to construct this measure.
Denominator: Children age 12-17 years
Numerator: Children received care in a well-functioning system; Children who did not receive care in a well-functioning system
Revisions and Changes: There were slight changes in three of the measures included in the overall system of care measure for youth age 12-17 years: shared decision making, medical home, and transition to adult care. Though small components of each of those three measures changed between 2017 and 2018, the overall approach to understanding and scoring these concepts did not change; therefore the measure is comparable over time.
Additional Notes: This measure is comprised of six age-relevant measures for children age 12-17 years. Those six measures for children age 12-17 years include: family feels like they are a partner in their child’s care, child has a medical home, child had a preventive medical and dental visit, child has adequate insurance, child has no unmet need or barriers to access services, and preparation for adult transition. 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 2016-2017 scoring of this measure. Respondents with "missing" to all items were set to missing.
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.
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C.I. = 95% Confidence Interval. Percentages and population estimates (Pop.Est.) are weighted to represent child population in US.
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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. 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].