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Development and Validation of a Method to Identify Children With Social Complexity Risk Factors.
Schrager, Sheree M; Arthur, Kimberly C; Nelson, Justine; Edwards, Anne R; Murphy, J Michael; Mangione-Smith, Rita; Chen, Alex Y.
Afiliación
  • Schrager SM; Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California; sschrager@chla.usc.edu.
  • Arthur KC; Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Washington;
  • Nelson J; Minnesota Department of Human Services, St. Paul, Minnesota;
  • Edwards AR; Park Nicollet Health Services, Minneapolis, Minnesota;
  • Murphy JM; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts;
  • Mangione-Smith R; Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; and.
  • Chen AY; Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California.
Pediatrics ; 138(3)2016 09.
Article en En | MEDLINE | ID: mdl-27516527
OBJECTIVES: We sought to develop and validate a method to identify social complexity risk factors (eg, limited English proficiency) using Minnesota state administrative data. A secondary objective was to examine the relationship between social complexity and caregiver-reported need for care coordination. METHODS: A total of 460 caregivers of children with noncomplex chronic conditions enrolled in a Minnesota public health care program were surveyed and administrative data on these caregivers and children were obtained. We validated the administrative measures by examining their concordance with caregiver-reported indicators of social complexity risk factors using tetrachoric correlations. Logistic regression analyses subsequently assessed the association between social complexity risk factors identified using Minnesota's state administrative data and caregiver-reported need for care coordination, adjusting for child demographics. RESULTS: Concordance between administrative and caregiver-reported data was moderate to high (correlation range 0.31-0.94, all P values <.01), with only current homelessness (r = -0.01, P = .95) failing to align significantly between the data sources. The presence of any social complexity risk factor was significantly associated with need for care coordination before (unadjusted odds ratio = 1.65; 95% confidence interval, 1.07-2.53) but not after adjusting for child demographic factors (adjusted odds ratio = 1.53; 95% confidence interval, 0.98-2.37). CONCLUSIONS: Social complexity risk factors may be accurately obtained from state administrative data. The presence of these risk factors may heighten a family's need for care coordination and/or other services for children with chronic illness, even those not considered medically complex.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Crónica / Indicadores de Salud / Poblaciones Vulnerables Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Patient_preference Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Crónica / Indicadores de Salud / Poblaciones Vulnerables Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Patient_preference Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos