U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Increase the proportion of children and adolescents with special health care needs who have a system of care — MICH‑20 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Survey of Children's Health (NSCH), HRSA/MCHB

Baseline: 15.7 percent of children and adolescents under 18 years with special health care needs received care in a family-centered, comprehensive, and coordinated system in 2016-17

Target: 19.5 percent

Numerator
Number of children and adolescents under 18 years with special health care needs who receive their care in a family-centered, comprehensive, and coordinated system.
Denominator
Number of children and adolescents under 18 years with special health care needs.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.10.
1
Target-setting method justification
Trend data were not available for this objective. A percentage point improvement was calculated using Cohen's h effect size of 0.1. This method was used because it was a statistically significant improvement from the baseline.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2016 through 2017 National Survey of Children's Health:

NUMERATOR:

DURING THE PAST 12 MONTHS, were any decisions needed about this child's health care services or treatment, such as whether to start or stop a prescription or therapy services, get a referral to a specialist, or have a medical procedure?

  1. Yes
  2. No

DURING THE PAST 12 MONTHS, how often did this child's doctors or other health care providers:

Discuss with you the range of options to consider for his or her health care or treatment?
  1. Always
  2. Usually
  3. Sometimes
  4. Never

DURING THE PAST 12 MONTHS, how often did this child's doctors or other health care providers:

Make it easy for you to raise concerns or disagree with recommendations for this child's health care?
  1. Always
  2. Usually
  3. Sometimes
  4. Never

DURING THE PAST 12 MONTHS, how often did this child's doctors or other health care providers:

Work with you to decide together which health care and treatment choices would be best for this child?
  1. Always
  2. Usually
  3. Sometimes
  4. Never

Do you have one or more persons you think of as this child's personal doctor or nurse?
A personal doctor or nurse is a health professional who knows this child well and is familiar with this child's health history.
This can be a general doctor, a pediatrician, a specialist doctor, a nurse practitioner, or a physician's assistant.

  1. Yes, one person
  2. Yes, more than one person
  3. No

Is there a place that this child USUALLY goes when he or she is sick or you or another caregiver needs advice about his or her health?

  1. Yes
  2. No
Where does this child USUALLY go? Mark ONE only.
  1. Doctor's Office
  2. Hospital Emergency Room
  3. Hospital Outpatient Department
  4. Clinic or Health Center
  5. Retail Store Clinic or "Minute Clinic"
  6. School (Nurse's Office, Athletic Trainer's Office)
  7. Some other place
Do you have one or more persons you think of as this child's personal doctor or nurse? A personal doctor or nurse is a
health professional who knows this child well and is familiar with this child's health history. This can be a general doctor, a
pediatrician, a specialist doctor, a nurse practitioner, or a physician's assistant.
  1. Yes, one person
  2. Yes, more than one person
  3. No

DURING THE PAST 12 MONTHS, did this child need a referral to see any doctors or receive any services?

  1. Yes
  2. No
How much of a problem was it to get referrals?
  1. Not a problem
  2. Small problem
  3. Big problem
Does anyone help you arrange or coordinate this child's care among the different doctors or services that this child uses?
  1. Yes
  2. No
  3. Did not see more than one health care provider in past 12 months
Overall, how satisfied are you with the communication among this child's doctors and other health care providers?
  1. Very Satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied

DURING THE PAST 12 MONTHS, did this child's health care provider communicate with this child's school, child care provider, or special education program?

  1. Yes
  2. No
  3. Did not need health care provider to communicate with these providers

DURING THE PAST 12 MONTHS, how often did this child's doctors or other health care providers: Spend enough time with this child?

  1. Always
  2. Usually
  3. Sometimes
  4. Never
How often does this child's health insurance offer benefits or cover services that meet this child's needs?
  1. Always
  2. Usually
  3. Sometimes
  4. Never
Is this child CURRENTLY covered by ANY kind of health insurance or health coverage plan?
  1. Yes
  2. No
How often does this child's health insurance allow him or her to see the health care providers he or she needs?
  1. Always
  2. Usually
  3. Sometimes
  4. Never
How often are these costs reasonable?
  1. Always
  2. Usually
  3. Sometimes
  4. Never
Including co-pays and amounts from Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA), how much money did you pay for this child medical, health, dental, and vision care DURING THE PAST 12 MONTHS?
Do not include health insurance premiums or costs that were or will be reimbursed by insurance or another source.
  1. $0 (No medical or health-related expenses)
  2. $1-$249
  3. $250-$499
  4. $500-$999
  5. $1,000-$5,000
  6. More than $5,000

DURING THE PAST 12 MONTHS, was this child EVER covered by ANY kind of health insurance or health coverage plan?

  1. Yes, this child was covered all 12 months
  2. Yes, but this child had a gap in coverage
  3. No

DURING THE PAST 12 MONTHS, how many times did this child visit a doctor, nurse, or other health care professional to receive a PREVENTIVE check-up?
A preventive check-up is when this child was not sick or injured, such as an annual or sports physical, or well-child visit.

  1. 0 visits
  2. 1 visit
  3. 2 or more visits

DURING THE PAST 12 MONTHS, did this child see a doctor, nurse, or other health care professional for sick-child care, well-child check-ups, physical exams, hospitalizations or any other kind of medical care?

  1. Yes
  2. No
Did this child see a dentist or other oral health care provider for preventive dental care, such as check-ups and dental cleanings, dental sealants, or fluoride treatments?
  1. No preventive visits in the past 12 months
  2. Yes, 1 visit
  3. Yes, 2 or more visits

DURING THE PAST 12 MONTHS, did this child see a dentist or other oral health care provider for any kind of dental or oral health care?

  1. Yes, saw a dentist
  2. Yes, saw other oral health care provider
  3. No

DURING THE PAST 12 MONTHS, how often were you frustrated in your efforts to get services for this child?

  1. Never
  2. Sometimes
  3. Usually
  4. Always

DURING THE PAST 12 MONTHS, was there any time when this child needed health care but it was not received?
By health care, we mean medical care as well as other kinds of care like dental care, vision care, and mental health services.

  1. Yes
  2. No
At his or her last preventive check-up, did this child have a chance to speak with a doctor or other health care provider privately, without you or another adult in the room?
  1. Yes
  2. No

DURING THE PAST 12 MONTHS, how many times did this child visit a doctor, nurse, or other health care professional to receive a PREVENTIVE check-up?
A preventive check-up is when this child was not sick or injured, such as an annual or sports physical, or well-child visit.

  1. 0 visits
  2. 1 visit
  3. 2 or more visits

Has this child's doctor or other health care provider actively worked with this child to:
Understand the changes in health care that happen at age 18.
For example, by understanding changes in privacy, consent, access to information, or decision-making?

  1. Yes
  2. No
  3. Don't know

Has this child's doctor or other health care provider actively worked with this child to:
Gain skills to manage his or her health and health care.
For example, by understanding current health needs, knowing what to do in a medical emergency, or taking medications he or she may need?

  1. Yes
  2. No
  3. Don't know
Do any of this child's doctors or other health care providers treat only children?
  1. Yes
  2. No
Have they talked with you about having this child eventually see doctors or other health care providers who treat adults?
  1. Yes
  2. No

Methodology notes

Between five and six indicators are used to measure the quality of a system of care for children with special health care needs (CSHCN) aged 0-17 (depending on age):Families of children and youth with special health care needs partner in decision making at all levels and are satisfied with the services they receive;Children and youth with special health care needs receive coordinated, updated, ongoing, comprehensive care within a medical home;Families of CSHCN have adequate private and/or public insurance to pay for the services they need;Children are screened early and continuously for special health care needs;Community-based services for children and youth with special health care needs are organized so families can use them easily;A child is considered to be served by a "service system," as described in the Healthy People objective, if his or her care met all relevant criteria for his or her age. For children from birth through age 17 years, the first five outcomes were included; an additional outcome related to health care transition planning is included only for children aged 12 through 17 years.

Children with special health care needs are identified using the CSHCN Screener3, which consists of five questions concerning common health care consequences.

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from the related Healthy People 2020 objectives in that it is a composite of MICH-31.1 and MICH-31.2, which used data from the National Survey of Children with Special Health Care Needs (NS-CSHCN) to track children ages 0 to 11 years and adolescents 12 to 17 years, respectively, receiving care in family-centered, comprehensive, and coordinated systems. The data source for this objective is the National Survey of Children's Health (NSCH).

1. Effect size h=0.1 was chosen to correspond with 10% improvement from a baseline of 50%.