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The Association Between Shared Decision-Making and Child Health in the General Pediatric Population
Alyssa Cohen1,2,3, Kelly N Michelson4,5, Michelle L Macy4,6,7
1Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 162, Chicago, IL, 60611, USA. acohen@luriechildrens.org.
Maternal and Child Health Journal
|April 15, 2026
Summary
Shared decision-making (SDM) in pediatrics reduces forgone health care and missed school days. This approach benefits all children, not just those with special health needs.
Area of Science:
- Pediatric Health Outcomes
- Healthcare Decision-Making
- Child Health Services Research
Background:
- Shared decision-making (SDM) improves outcomes for children with special healthcare needs.
- The impact of SDM on the general pediatric population remains less understood.
- SDM involves collaboration between patients and healthcare providers.
Purpose of the Study:
- To investigate the association between SDM and child health and healthcare utilization.
- To examine SDM's role in forgone care, missed school days, and emergency department visits.
- To analyze SDM in a national sample of children.
Main Methods:
- Utilized data from the 2019-2021 National Survey of Children's Health.
- Conducted bivariate and multivariable logistic regression analyses.
- Adjusted for sociodemographic variables to assess SDM's impact.
Main Results:
- 85% of the 31,791 children experienced SDM.
- SDM was linked to significantly lower odds of forgone needed health care (aOR=0.22).
- SDM was associated with fewer missed school days (aOR=0.80) but not ED visits.
Conclusions:
- SDM may offer benefits to the general pediatric population.
- Experiencing SDM is associated with reduced forgone healthcare and fewer missed school days.
- Further research should explore family-centered SDM approaches in pediatrics.
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