viernes, 16 de septiembre de 2016

Development and Validation of a Method to Identify Children With Social Complexity Risk Factors. - PubMed - NCBI

Development and Validation of a Method to Identify Children With Social Complexity Risk Factors. - PubMed - NCBI



 2016 Sep;138(3). pii: e20153787. doi: 10.1542/peds.2015-3787. Epub 2016 Aug 11.

Development and Validation of a Method to Identify Children With Social Complexity Risk Factors.

Abstract

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.
Copyright © 2016 by the American Academy of Pediatrics.

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