Does the FACCT Special Health Care Needs Screener Produce Biased Estimates of Children with Chronic Conditions?

Julia A. Drew, Brown University

During the past two decades, public health researchers have aimed to create better survey-based measures of children with chronic conditions. Although there is no acknowledged “gold-standard” for identifying these children, the Foundation for Accountability (FACCT) screener has become the de facto method of providing population estimates of children with chronic conditions. However, the primary assumption underlying the FACCT screener is that chronic conditions can be identified equally well for all children by parental report of need for specialty health care services. This premise is problematic because it assumes that all children have an equal chance of being identified as “needy” in the first place. This paper uses the 2002 National Health Interview Survey to investigate whether there are systematic differences in who is identified as having a chronic condition. Preliminary results indicate that access to health care, race/ethnicity, and parental education are related to being identified, whereas income is not.