nach oben

Maternal and Child Health Journal

Erschienen in:

16.07.2016

Disparities in Quality and Access to Care for Children with Developmental Disabilities and Multiple Health Conditions

verfasst von: Nancy C. Cheak-Zamora, Matthew Thullen

Erschienen in: Maternal and Child Health Journal | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

The Maternal Child Health Bureau identified six indicators of quality and accessibility essential in achieving coordinated, family-centered, community-based care for children with special healthcare needs (CSHCN). Previous research examined associations between children with single conditions and individual indicators. We sought to identify disparities in meeting quality and accessibility indicators for children with different condition types.

Methods

The 2009–2010 National Survey of CSHCN is a nationally representative cross-sectional study with caregiver’s reports on 40,242 children (0–17 years). Children were categorized into one of seven conditions groups: physical health (PHC), mental health (MHC), developmental disability (DD), physical and mental (PHC and MHC), physical and developmental (PHC and DD), mental and developmental (MHC and DD) and physical, mental and developmental (PHC, MHC, and DD). Unadjusted and adjusted analyses determined associations between condition group and quality and access indicators.

Results

Children with DD, alone or in combination with another condition, were significantly less likely to meet each indicator (p < 0.01) after adjusting for individual demographic, child’s activity limitations and family-related characteristics. Compared with children with PHC, those with all three conditions (PHC, MHC, and DD) had the lowest odds of access to medical home (61 % decreased odds (DO)), community services (67 % DO), and adequate insurance (26 % DO); MHC and DD had the lowest odds of partnering in decision making (51 % DO); DD had the lowest odds of healthcare transition service (66 % DO).

Conclusions

Children with DD and multiple conditions experience disparities in quality and access to healthcare services, meeting most indictors half as often as other CSHCN.

Beal, A. C., Dougherty, D., Jorsling, T., Kam, J., Perrin, J., & Palmer, R. H. (2004). Quality measures for children’s health care. Pediatrics, 113(Supplement 1), 199–209.PubMed

Busch, S. H., & Barry, C. L. (2009). Does private insurance adequately protect families of children with mental health disorders? Pediatrics, 124(Supplement 4), S399–S406.CrossRefPubMedPubMedCentral

Cheak-Zamora, N. C., Yang, X., Farmer, J. E., & Clark, M. (2013). Disparities in transition planning for youth with autism spectrum disorder. Pediatrics, 131(3), 447–454.CrossRefPubMed

Chen, A. Y., Schrager, S. M., & Mangione-Smith, R. (2012). Quality measures for primary care of complex pediatric patients. Pediatrics, 129(3), 433–445.CrossRefPubMed

Child and Adolescent Health Measurement Initiative. (2012). National profile of children with special health care needs and autism specrum disorders: Key findings from the 2009/10 NS-CSHCN and 2007 NSCH. Retrieved from www.childhealthdata.org.

Chiri, G., & Warfield, M. (2012). Unmet need and problems accessing core health care services for children with autism spectrum disorder. Maternal and Child Health Journal, 16(5), 1081–1091. doi:10.1007/s10995-011-0833-6.CrossRefPubMed

Cohen, E., Kuo, D. Z., Agrawal, R., Berry, J. G., Bhagat, S. K., Simon, T. D., et al. (2011). Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics, 127(3), 529–538.CrossRefPubMedPubMedCentral

Coller, R. J., Nelson, B. B., Sklansky, D. J., Saenz, A. A., Klitzner, T. S., Lerner, C. F., & Chung, P. J. (2014). Preventing hospitalizations in children with medical complexity: A systematic review. Pediatrics, 134(6), 1–20.CrossRef

DuPaul, G. J., Carson, K. M., & Fu, Q. (2013). Medical home care for children with special needs: Access to services and family burden. Children’s Health Care, 42(1), 27–44.CrossRef

Fedele, D. A., Molzon, E. S., Eddington, A. R., Hullmann, S. E., Mullins, L. L., & Gillaspy, S. G. (2014). Perceived barriers to care in a pediatric medical home the moderating role of caregiver minority status. Clinical Pediatrics, 53(4), 351–355.CrossRefPubMed

Halfon, N., Houtrow, A., Larson, K., & Newacheck, P. W. (2012). The changing landscape of disability in childhood. The Future of Children, 22(1), 13–42.CrossRefPubMed

Halfon, N., Larson, K., Lu, M., Tullis, E., & Russ, S. (2014). Lifecourse health development: Past, present and future. Maternal and Child Health Journal, 18(2), 344–365. doi:10.1007/s10995-013-1346-2.CrossRefPubMed

Houtrow, A. J., Okumura, M. J., Hilton, J. F., & Rehm, R. S. (2011). Profiling health and health-related services for children with special health care needs with and without disabilities. Academic Pediatrics, 11(6), 508–516.CrossRefPubMedPubMedCentral

Jobe, J. B., White, A. A., Kelley, C. L., Mingay, D. J., Sanchez, M. J., & Loftus, E. F. (1990). Recall strategies and memory for health-care visits. The Milbank Quarterly, 68(2), 171–189. doi:10.2307/3350095.CrossRefPubMed

Kenney, M. K., & Mann, M. (2013). Assessing systems of care for US children with epilepsy/seizure disorder. Epilepsy Research and Treatment. doi:10.1155/2013/825824.PubMedPubMedCentral

Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005 2006. Pediatrics, 122, e1149–e1158.CrossRefPubMed

Krauss, M. W., Gulley, S., Sciegaj, M., & Wells, N. (2003). Access to specialty medical care for children with mental retardation, autism, and other special health care needs. Mental Retardation, 41(5), 329–339.CrossRefPubMed

Liptak, G. S., Orlando, M., Yingling, J. T., Theurer-Kaufman, K. L., Malay, D. P., Tompkins, L. A., et al. (2006). Satisfaction with primary health care received by families of children with developmental disabilities. Journal of Pediatric Health Care, 20(4), 245–252.CrossRefPubMed

Litt, J. S., & McCormick, M. C. (2015). Care coordination, the family-centered medical home, and functional disability among children with special health care needs. Academic Pediatrics, 15(2), 185–190.CrossRefPubMed

Lollar, D. J., Hartzell, M. S., & Evans, M. A. (2012). Functional difficulties and health conditions among children with special health needs. Pediatrics,. doi:10.1542/peds.2011-0780.PubMed

Maternal and Child Health Bureau. (2008). The National Survey of Children with Special Health Care Needs Chartbook 2005–2006. Rockville, MD..

McGrath, R. J., Laflamme, D. J., Schwartz, A. P., Stransky, M., & Moeschler, J. B. (2009). Access to genetic counseling for children with autism, Down syndrome, and intellectual disabilities. Pediatrics, 124(Suppl 4), S443–S449.CrossRefPubMed

Montes, G., Halterman, J. S., & Magyar, C. I. (2009). Access to and satisfaction with school and community health services for US children with ASD. Pediatrics, 124(Supplement 4), S407–S413.CrossRefPubMed

Nageswaran, S., Parish, S. L., Rose, R. A., & Grady, M. D. (2011). Do children with developmental disabilities and mental health conditions have greater difficulty using health services than children with physical disorders? Maternal Child Health Journal, 15, 634–641.CrossRefPubMed

Nageswaran, S., Silver, E. J., & Stein, R. E. (2008). Association of functional limitation with health care needs and experiences of children with special health care needs. Pediatrics, 121(5), 994–1001.CrossRefPubMed

Newacheck, P. W., & Kim, S. E. (2005). A national profile of health care utilization and expenditures for children with special health care needs. Archives of Pediatrics and Adolescent Medicine, 159(1), 10–17.CrossRefPubMed

Park, M. J., Adams, S. H., & Irwin, C. E. (2011). Health care services and the transition to young adulthood: challenges and opportunities. Academic Pediatrics, 11(2), 115–122.CrossRefPubMed

Porterfield, S. L., & DeRigne, L. (2011). Medical home and out-of-pocket medical costs for children with special health care needs. Pediatrics, 128(5), 892–900.CrossRefPubMed

Raphael, J. L., Mei, M., Brousseau, D. C., & Giordano, T. P. (2011). Associations between quality of primary care and health care use among children with special health care needs. Archives of Pediatrics and Adolescent Medicine, 165(5), 399–404. doi:10.1001/archpediatrics.2011.33.CrossRefPubMed

Strickland, B. B., Jones, J. R., Newacheck, P. W., Bethell, C. D., Blumberg, S. J., & Kogan, M. D. (2014). Assessing systems quality in a changing health care environment: The 2009-10 National Survey of Children with Special Health Care Needs. Maternal and Child Health Journal,. doi:10.1007/s10995-014-1517-9.

Strickland, B. B., van Dyck, P. C., Kogan, M. D., Lauver, C., Blumberg, S. J., Bethell, C. D., et al. (2011). Assessing and ensuring a comprehensive system of services for children with special health care needs: a public health approach. American Journal of Public Health, 101(2), 224–231. doi:10.2105/AJPH.2009.177915.CrossRefPubMedPubMedCentral

van Dyck, P. C., McPherson, M., Strickland, B. B., Nesseler, K., Blumberg, S. J., Cynamon, M. L., et al. (2002). The national survey of children with special health care needs. Ambulatory Pediatrics, 2(1), 29–37.CrossRefPubMed

Vohra, R., Madhavan, S., Sambamoorthi, U., & St Peter, C. (2014). Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions. Autism, 18(7), 815–826.CrossRefPubMed

Titel: Disparities in Quality and Access to Care for Children with Developmental Disabilities and Multiple Health Conditions
verfasst von: Nancy C. Cheak-Zamora
Matthew Thullen
Publikationsdatum: 16.07.2016
Verlag: Springer US
Erschienen in: Maternal and Child Health Journal / Ausgabe 1/2017
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-2091-0

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Disparities in Quality and Access to Care for Children with Developmental Disabilities and Multiple Health Conditions

Abstract

Background

Methods

Results

Conclusions

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2017

Weight Misperception and Health-Related Quality of Life in Appalachian Adolescents in the United States

Motor Skill Competence and Physical Activity in Preschoolers: A Review

A Process Evaluation of the WV Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Initiative: Assessing the Fidelity and Impact of Delivery for State-Wide, Home-Based Healthy Start Services

Attachment to Conventional Institutions and Adolescent Rapid Repeat Pregnancy: A Longitudinal National Study Among Adolescents in the United States

Weight-Gain Velocity in Newborn Infants Managed with the Kangaroo Method and Associated Variables

Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings