Abstract
Objective
The aims of this study were to profile and compare the health and health services
characteristics for children with special health care needs (CSHCN), with and without
disabilities, and to determine factors associated with unmet need.
Methods
Secondary data analysis of the 2005–2006 National Survey of Children with Special
Health Care Needs was conducted. The sociodemographics, health, and health services
of CSHCN with and without disabilities were compared. Multivariable logistic regression
was employed to examine factors associated with unmet need for health services.
Results
Children from minority racial and ethnic groups and children living in or near poverty
were over-represented among CSHCN with disabilities, compared with other CSHCN. Statistically
higher percentages of CSHCN with disabilities had behavioral problems (39.6% vs 25.2%),
anxiety/depressed mood (46.1% vs 24.0%), and trouble making/keeping friends (38.1%
vs 15.6%) compared with other CSHCN. Thirty-two percent of CSHCN with disabilities
received care in a medical home compared with 51% of other CSHCN. CSHCN with disabilities
had higher rates of need and unmet need than other CSHCN for specialty care, therapy
services, mental health services, home health, assistive devices, medical supplies,
and durable medical equipment. The adjusted odds of unmet need for CSHCN with disabilities
were 71% higher than for other CSHCN.
Conclusion
CSHCN with disabilities had more severe health conditions and more health services
need, but they less commonly received care within a medical home and had more unmet
need. These health care inequities should be amenable to policy and health service
delivery interventions to improve outcomes for CSHCN with disabilities.
Keywords
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Article Info
Publication History
Published online: October 03, 2011
Accepted:
August 18,
2011
Received:
March 1,
2011
Identification
Copyright
© 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
