To further evaluate the system of care serving CSHCN, the core outcomes were combined into a single indicator of “system-ness.” A child was considered to be served by a well-functioning “service system,” as described in the Healthy People objective, if his or her care met all relevant criteria for his or her age. For children from birth through age 11, the first 5 outcomes were included, and all 6 outcomes were counted for children from age 12 through 17.

Among children aged 11 and under, 20.1 percent were served by a well-functioning system of care according to these standards. For children aged 12-17, 13.6 percent had care that met all 6 criteria. For children whose conditions have a greater impact on their daily lives, these outcomes were much more difficult to achieve. Among 0- to 11-year-olds whose conditions consistently affect their activities, only 10.5 percent are served by systems of care that meet all 5 criteria; among 12- to 17-year-olds, only 6.0 percent met all 6. Among children whose conditions never affect their activities, a greater percentage were served by a system that met all of the outcomes (29.6 percent of children aged 0-11 and 22.1 percent of those aged 12-17).

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