Comparison of Experiences with Care Coordination for Children with Special Healthcare Needs (CSHCN) in IllinoisSarah A Sobotka*, Parag K Shah and Karen M Sheehan
Department of Pediatrics, University of Chicago, Chicago, IL, United States and 2Pediatrics, Northwestern University, Chicago, IL, USA
- *Corresponding Author:
- Sarah Ann Sobotka
Department of Developmental-Behavioral Pediatrics
University of Chicago, 950 E. 61st Street
SSC Building Rm. 207, Chicago, IL 60637
Tel: 773 702 3095
E-mail: [email protected]
Received date: June 29, 2014; Accepted date: September 03, 2014; Published date: September 03, 2014
Citation: Sobotka SA, Shah PK, Sheehan KM (2014) Comparison of Experiences with Care Coordination for Children with Special Healthcare Needs (CSHCN) in Illinois. J Community Med Health Educ 4:307. doi: 10.4172/2161-0711.1000307
Copyright: © 2014 Sobotka SA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Care coordination (CC), a central responsibility of the medical home, significantly impacts health outcomes of CSHCN. Most studies to date have focused on either provider provision of CC or patient experience with CC. Objective: We compared how providers for, and parents of, CSHCN experience subspecialty access, communication amongst physicians, and barriers to CC, and examined associated characteristics. Methods: Two datasets were analyzed: a survey of Illinois primary care pediatricians and the Illinois sample within the National Survey of CSHCN. Results: 376 physicians and 793 parents were analyzed. Providers and parents were highly satisfied with obtaining subspecialty referrals and with communication amongst doctors (76-92%), however 41% of parents and 38% of physicians identified CC barriers. Doctors more frequently reported CC barriers if employed by community hospitals (OR: 2.4 [95%CI: 1.2-4.6]), without academic appointments (OR: 1.6[1-2.4]), did not participate in a medical home project (OR: 4.5[1.7-12.1]), or cared for an overrepresentation of Hispanic patients (OR: 2.1[1.2-3.8]). Parents were 60% less likely to report poor doctor communication if they had a primary caregiver and 60% less likely to report difficulty with referrals if they had a usual place for care. Conclusions: Patients and physicians are overall highly satisfied with access to and communication with subspecialists, however over a third of parents and physicians of CSHCN, particularly non-academic community providers, report CC barriers.