Comparing States on Outcomes for Children with Special Health Care Needs
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Objectives: To develop two alternative methods for comparing and ranking states on the health, health care, and well-being of children with special health care needs (CSHCN). Methods: Fifteen key indicators of CSHCN’s functional abilities, health insurance coverage, access to care, and the impact of their conditions on their families were identified from the 2001 National Survey of Children with Special Health Care Needs. An initial composite score for each state was created by averaging the state’s standardized scores for each of these indicators. Using linear regression analyses and standardized residuals, an adjusted composite score for each state was then created that accounted for demographic variables that differed by state and were related to the initial composite score. States were ranked based on the initial and adjusted composite scores. Results: The initial composite scores were related to population differences by poverty status, African-American race, and the prevalence of special health care needs. Compared to ranks based on the initial scores, ranks based on the adjusted scores shifted by 10 or more positions for half the states. Hawaii, Rhode Island, Arizona, Iowa, and North Dakota had the highest (“best”) adjusted scores. Conclusion: Adjustment to the initial composite scores permits states with different demographic compositions to be compared. The adjusted scores may also help raise awareness of CSHCN’s concerns in states where demographic compositions favorable to health outcomes mask the fact that these outcomes are only average (or worse) given the states’ demographic compositions.
- Nelson R. The legislative base of programs for children with special health care needs. In: Wallace HM, Nelson RP, Sweeney PJ, editors. Maternal and Child Health Practices. Oakland CA: Third Party Publishing Company, 1994:681–6.
- van Dyck PC, McPherson M, Strickland BB, Nesseler K, Blumberg SJ, Cynamon ML, Newacheck PW. The national survey of children with special health care needs. Ambul Pediatr 2002;2:29–37. CrossRef
- Annie E. Casey Foundation. Kids Count Data Book. Baltimore MD: Annie E. Casey Foundation, 2004. Available at http://www.aecf.org/kidscount/databook.
- Engel SM, Field C, Finkelhor D. State child well-being ranking: Alternative approaches. Durham, NH: University of New Hampshire Sociology Department, 2000. Available at http://www.unh.edu/frl/pdf2/kidscount.pdf.
- Ricketts TC. Geography and disparities in health care. In: Swift EK, editor. Guidance for the National Healthcare Disparities Report. Washington DC: The National Academies Press, 2002:149–80.
- Ham SA, Levin S, Zlot AI, Andrews RR, Miles R. Ranking of cities according to public health criteria: Pitfalls and opportunities. Am J Public Health 2004;94:546–9.
- McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B. A new definition of children with special health care needs. Pediatrics 1998;102:137–9.
- Bethell CD, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW. Identifying children with special health care needs: Development and evaluation of a short screening tool. Ambul Pediatr 2002;2:38–48. CrossRef
- Blumberg SJ, Olson L, Frankel M, Osborn L, Becker CJ, Srinath KP, Giambo P. Design and operation of the National Survey of Children with Special Health Care Needs, 2001. National Center for Health Statistics. Vital Health Stat 1 2003;41:1–136.
- Child and Adolescent Health Measurement Initiative. From information to action: Data resource center for child and adolescent health. Available at http://www.cshcndata.org.
- U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. The National Survey of Children with Special Health Care Needs Chartbook 2001. Rockville, MD: U.S. Department of Health and Human Services, 2004. Available at http://mchb.hrsa.gov/chscn.
- Bartman BA, Moy E, D’Angelo LJ. Access to ambulatory care for adolescents: The role of a usual source of care. J Health Care Poor Underserved 1997;8:214–26.
- Ryan S, Riley A, Kang M, Starfield B. The effects of regular source of care and health need on medical care use among rural adolescents. Arch Pediatr Adolesc Med 2001;155:184–90.
- Starfield B, Shi L. The medical home, access to care, and insurance: A review of evidence. Pediatrics 2004;113:1493–8.
- Strickland B, McPherson M, Weissman G, van Dyck P, Huang ZJ, Newacheck P. Access to the medical home: Results of the National Survey of Children With Special Health Care Needs. Pediatrics 2004;113:1485–92.
- Gerzoff RB, Williamson GD. Who’s number one? The impact of variability on rankings based on public health indicators. Public Health Rep 2001;116:158–64.
- Comparing States on Outcomes for Children with Special Health Care Needs
Maternal and Child Health Journal
Volume 9, Issue 2 Supplement, pp S121-S128
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- statistical ranking
- child health
- state estimates
- children with special health care needs
- Industry Sectors