TY - JOUR
T1 - Taking stock of the CSHCN screener
T2 - A review of common questions and current reflections
AU - Bethell, Christina D.
AU - Blumberg, Stephen J.
AU - Stein, Ruth E.K.
AU - Strickland, Bonnie
AU - Robertson, Julie
AU - Newacheck, Paul W.
N1 - Funding Information:
Supported through the Child and Adolescent Health Measurement Initiative and the National Data Resource Center for Child and Adolescent Health, funded by the federal Maternal and Child Health Bureau through Cooperative Agreement 1-U59-MC06980-01. The views expressed in this report are those of the authors and do not necessarily represent those of the Health Resources and Services Administration or the US Centers for Disease Control and Prevention/National Center for Health Statistics. The authors thank Narangeral Gombojav, PhD, for periodic data analysis assistance.
Publisher Copyright:
© 2015 Academic Pediatric Association.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Since 2000, the Children with Special Health Care Needs (CSHCN) Screener (CS) has been widely used nationally, by states, and locally as a standardized and brief survey-based method to identify populations of children who experience chronic physical, mental, behavioral, or other conditions and who also require types and amounts of health and related services beyond those routinely used by children. Common questions about the CS include those related to its development and uses; its conceptual framework and potential for under- or overidentification; its ability to stratify CSHCN by complexity of service needs and daily life impacts; and its potential application in clinical settings and comparisons with other identification approaches. This review recaps the development, design, and findings from the use of the CS and synthesizes findings from studies conducted over the past 13 years as well as updated findings on the CS to briefly address the 12 most common questions asked about this tool through technical assistance provided regarding the CS since 2001. Across a range of analyses, the CS consistently identifies a subset of children with chronic conditions who need or use more than a routine type or amount of medical- and health-related services and who share common needs for health care, including care coordination, access to specialized and community-based services, and enhanced family engagement. Scoring algorithms exist to stratify CSHCN by complexity of needs and higher costs of care. Combining CS data with clinical diagnostic code algorithms may enhance capacity to further identify meaningful subgroups. Clinical application is most suited for identifying and characterizing populations of patients and assessing quality and system improvement impacts for children with a broad range of chronic conditions. Other clinical applications require further implementation research. Use of the CS in clinical settings is limited because integration of standardized patient-reported health information is not yet common practice in most settings or in electronic health records. The CS continues to demonstrate validity as a non-condition-specific, population-based tool that addresses many of the limits of condition or diagnosis checklists, including the relatively low prevalence of many individual conditions and substantial within-diagnosis variations and across-diagnoses similarities in health service needs, functioning, and quality of care.
AB - Since 2000, the Children with Special Health Care Needs (CSHCN) Screener (CS) has been widely used nationally, by states, and locally as a standardized and brief survey-based method to identify populations of children who experience chronic physical, mental, behavioral, or other conditions and who also require types and amounts of health and related services beyond those routinely used by children. Common questions about the CS include those related to its development and uses; its conceptual framework and potential for under- or overidentification; its ability to stratify CSHCN by complexity of service needs and daily life impacts; and its potential application in clinical settings and comparisons with other identification approaches. This review recaps the development, design, and findings from the use of the CS and synthesizes findings from studies conducted over the past 13 years as well as updated findings on the CS to briefly address the 12 most common questions asked about this tool through technical assistance provided regarding the CS since 2001. Across a range of analyses, the CS consistently identifies a subset of children with chronic conditions who need or use more than a routine type or amount of medical- and health-related services and who share common needs for health care, including care coordination, access to specialized and community-based services, and enhanced family engagement. Scoring algorithms exist to stratify CSHCN by complexity of needs and higher costs of care. Combining CS data with clinical diagnostic code algorithms may enhance capacity to further identify meaningful subgroups. Clinical application is most suited for identifying and characterizing populations of patients and assessing quality and system improvement impacts for children with a broad range of chronic conditions. Other clinical applications require further implementation research. Use of the CS in clinical settings is limited because integration of standardized patient-reported health information is not yet common practice in most settings or in electronic health records. The CS continues to demonstrate validity as a non-condition-specific, population-based tool that addresses many of the limits of condition or diagnosis checklists, including the relatively low prevalence of many individual conditions and substantial within-diagnosis variations and across-diagnoses similarities in health service needs, functioning, and quality of care.
KW - Medical Expenditures Panel Survey
KW - National Survey of Children With Special Health Care Needs
KW - National Survey of Childrens Health
KW - children with chronic conditions
KW - children with special health care needs
KW - complex CSHCN
UR - http://www.scopus.com/inward/record.url?scp=84924350398&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924350398&partnerID=8YFLogxK
U2 - 10.1016/j.acap.2014.10.003
DO - 10.1016/j.acap.2014.10.003
M3 - Review article
C2 - 25486969
AN - SCOPUS:84924350398
SN - 1876-2859
VL - 15
SP - 165
EP - 176
JO - Academic pediatrics
JF - Academic pediatrics
IS - 2
ER -