Abstract
This study examined geographic, racial/ethnic, and sociodemographic disparities in parental reporting of receipt of family-centered care (FCC) and its components among US children aged 0–17 years. We used the 2011-2012 National Survey of Children's Health to estimate the prevalence and odds of not receiving FCC by covariates. Based on parent report, 33.4% of US children did not receive FCC. Children in Arizona, Mississippi, Nevada, California, New Jersey, Virginia, Florida, and New York had at least 1.51 times higher adjusted odds of not receiving FCC than children in Vermont. Non-Hispanic Black and Hispanic children had 2.11 and 1.58 times higher odds, respectively, of not receiving FCC than non-Hispanic White children. Children from non-English-speaking households had 2.23 and 2.35 times higher adjusted odds of not receiving FCC overall and their doctors not spending enough time in their care than children from English-speaking households, respectively. Children from low-education and low-income households had a higher likelihood of not receiving FCC. The clustering of children who did not receive FCC and its components in several Southern and Western US states, as well as children from poor, uninsured, and publicly insured and of minority background, is a cause for concern in the face of federal policies to reduce health care disparities.
Highlights
Family-centered care (FCC) is a collaborative approach to health care where family perspective is central to health care decision-making and represents a core aspect of a system of health care that focuses on the needs of all children in the United States [1]
This clarion call against the background of our findings that parents of children from nonEnglish-speaking households and from ethnic minority backgrounds such as non-Hispanic Black and Hispanic children reported disproportionately higher odds of parents reporting that health care providers were not being sensitive to their family’s customs and values is poignant
Primary care is the cornerstone of every health care system devoted to improving health outcomes and reducing health disparities [32]
Summary
Family-centered care (FCC) is a collaborative approach to health care where family perspective is central to health care decision-making and represents a core aspect of a system of health care that focuses on the needs of all children in the United States [1]. FCC is an important aspect of the quality of a medical home which is defined as a model of primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective [3]. For nearly five decades since it was first espoused, FCC, as a component of the medical home, has been advanced as an important part of quality care delivery by leading health professional associations, family advocates, and public health policy organizations, including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians, and the American Osteopathic Association, the Institute of Medicine, and the federal Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA) [4,5,6]. Healthy People 2020 identifies the ability to find a health care provider with whom the patient can communicate and trust as one of the public policy linchpins for improving access to comprehensive, quality health care services [7]. Family-patient-centered care is an essential feature of primary care whose mission is to provide entry into the health service system, provide person-focused care over time, provide care for all but very uncommon or unusual conditions, and coordinate or integrate care provided elsewhere or by others [10]
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