Shared decision making and behavioral impairment: a national study among children with special health care needs

BMC Pediatrics

Table 2 Comparing Characteristics of Children with Special Health Care Needs (CSHCN), Age 5-17 Years, by Shared Decision Making Pattern ¹

Variable	Included	Excluded	Pvalue comparing Included vs. excluded²
Number of children in sample	2454	174
Number of children represented in population	10.2 million	641,000
Percent represented	94%	6%
Demographic Characteristics	%	%
Age (Years)
5-12	70.0	64.1	0.2
13-17	30.0	35.9
Female	44.0	44.3	0.9
Race
White	78.4	69.6	0.009
Black	16.1	18.5
Other	5.5	11.9
Hispanic	12.5	16.9	0.1
Region
Northeast	19.1	8.1	0.02
Midwest	22.8	22.7
South	37.8	49.2
West	20.3	20.0
Parental Education
No Degree	10.3	17.8	0.1
High School Complete	46.4	48.2
Bachelor's Degree	16.7	12.8
Graduate Level Degree	11.9	11.6
Other Degree	14.7	9.6
Poverty
Poor	18.4	22.2	0.007
Near Poor	5.9	8.9
Low Income	15.0	24.9
Middle Income	31.5	27.5
High Income	29.2	16.5
Insurance Coverage
Any private	65.4	52.9	0.01
Other	34.6	47.1
Clinical Characteristics	%	%
General Health Status³
Increasing	20.4	20.1	0.9
Unchanged	59.8	60.4
Decreasing	19.8	19.5
Diagnosed with ADHD	19.8	8.3	0.001
Variable	Included	Excluded	P value comparing Included vs. excluded ²
Diagnosed with Asthma	20.1	19.3	0.8
Any psychotropic medication use⁴
None	70.7	85.6	0.01
Year 1 only	2.9	2.8
Year 2 only	6.1	3.9
Both years	20.3	6.7
Any mental health services use⁵
None	76.5	68.8	<0.001
Year 1 only	6.1	20.1
Year 2 only	6.8	5.8
Both years	10.6	5.3

¹Children excluded from the study lacked a usual source of care, had no response to any of the items used to create the SDM measure, or lacked a response to items from the Columbia Impairment Scale used to assess behavioral impairment.
² P values calculated by chi-square tests with robust variance estimates accounting for the weighted, clustered, and stratified longitudinal MEPS survey design.
³General Health Status determined using the overall score from 5 Likert-scaled items (recoded so that a score of 5 indicates the best health and a score of 1 the worst health) derived from the Child Health Questionnaire, General Health Subscale (child seems less healthy than other children, child has never been seriously ill, child usually catches whatever is going around, expect child will have a healthy life, respondent worries more than is usual about child’s health). For each year, the overall score was categorized as (low (<15), medium (15 to <20), or high (≥20)).
⁴ Psychotropic medications considered included stimulants, antidepressants, antipsychotics, anticonvulsants, as well as other psychotropic medications such as alpha agonists.
⁵ Mental health services include visits to a psychiatrist, psychologist, or other mental health professional.

ISSN: 1471-2431