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Profiling Health and Health-Related Services for Children With Special Health Care Needs With and Without Disabilities

  • Amy J. Houtrow
    Correspondence
    Address correspondence to: Amy J. Houtrow, MD, MPH, 500 Parnassus Ave, Box 0136, San Francisco, California 94143.
    Affiliations
    Department of Pediatrics (Dr Houtrow and Dr Okumura), Department of Biostatistics (Dr Hilton); and Department of Family Health Care Nursing (Dr Rehm), University of California, San Francisco, San Francisco, Calif
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  • Megumi J. Okumura
    Affiliations
    Department of Pediatrics (Dr Houtrow and Dr Okumura), Department of Biostatistics (Dr Hilton); and Department of Family Health Care Nursing (Dr Rehm), University of California, San Francisco, San Francisco, Calif
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  • Joan F. Hilton
    Affiliations
    Department of Pediatrics (Dr Houtrow and Dr Okumura), Department of Biostatistics (Dr Hilton); and Department of Family Health Care Nursing (Dr Rehm), University of California, San Francisco, San Francisco, Calif
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  • Roberta S. Rehm
    Affiliations
    Department of Pediatrics (Dr Houtrow and Dr Okumura), Department of Biostatistics (Dr Hilton); and Department of Family Health Care Nursing (Dr Rehm), University of California, San Francisco, San Francisco, Calif
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Published:October 03, 2011DOI:https://doi.org/10.1016/j.acap.2011.08.004

      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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