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Development and Implementation of the Family Experiences With Coordination of Care Survey Quality Measures
Courtney Gidengil1, Layla Parast2, Q Burkhart2
1RAND Corporation, Boston, Mass; Division of Infectious Diseases, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
Insights
A new survey, the Family Experiences with Coordination of Care (FECC), assesses care coordination for children with medical complexity (CMC). Mixed-mode survey administration yielded higher response rates, proving feasible for evaluating care quality.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Quality Improvement
Background:
- Children with medical complexity (CMC) represent a significant portion of pediatric healthcare costs.
- Effective care coordination is crucial for improving health and economic outcomes for CMC.
- Existing methods for assessing care coordination quality for CMC are limited.
Purpose of the Study:
- To develop and field test the Family Experiences with Coordination of Care (FECC) survey.
- To establish 20 new caregiver-reported quality measures for CMC care coordination.
- To assess the feasibility and effectiveness of different survey administration modes.
Main Methods:
- Caregivers of Medicaid-insured CMC (aged 0-17) in MN and WA were identified.
- Caregivers were randomized to telephone or mixed-mode (mail/telephone) survey administration.
- The Pediatric Medical Complexity Algorithm was used for categorization.
Main Results:
- 1209 caregivers responded to the FECC survey (41% response rate).
- Mixed-mode administration resulted in a higher response rate compared to telephone-only.
- Few children had written care plans (shared, emergency, or transition).
Conclusions:
- The FECC survey is a viable tool for evaluating care coordination quality in CMC.
- Mixed-mode survey administration is more effective in achieving higher response rates.
- The survey highlights areas for improvement in care planning for CMC.
Objective:
Ensuring high-quality care coordination for children with medical complexity (CMC) could yield significant health and economic benefits because they account for one-third of pediatric health care expenditures. The objective of this study was to develop and field test the Family Experiences with Coordination of Care (FECC) survey, which facilitates assessment of 20 new caregiver-reported quality measures for CMC.
Methods:
We identified caregivers of Medicaid-insured CMC aged 0 to 17 years in Minnesota and Washington state, categorized by the Pediatric Medical Complexity Algorithm as having complex chronic disease. Eligible caregivers had CMC with at least 4 visits to health care providers participating in Medicaid in 2012. Caregivers were randomized to telephone or mixed mode (mail with telephone follow-up). Survey administration and data were collected in 2013.
Results:
Twelve hundred nine caregivers responded to the FECC survey (response rate, 41%; 36% via telephone only, 46% via mixed mode; P < .001). Among CMC with a hospitalization, caregivers were invited to join hospital rounds in 51% of cases. Seventy-two percent of caregivers reported their child had a care coordinator; among these, 96% reported knowing how to access the care coordinator. Few children had written shared care plans (44%) or emergency care plans (20%). Only 10% of adolescents had a written transition care plan. Scores were lower from mixed mode respondents than from telephone-only respondents for some measures.
Conclusions:
The FECC survey enables the evaluation of care coordination quality for CMC. Both survey modes were feasible to implement, but mixed mode administration produced a higher response rate.