Utilization of special services among children and youth with special healthcare needs: A time-to-event analysis of the national survey of children's health data, 2016-2022.

IF 3.7 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Suman Kanti Chowdhury, Jennifer Marshall, Janice Zgibor, Russell S Kirby
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引用次数: 0

Abstract

Background: Special services including physical, occupational, speech, or behavioral therapies are associated with enhanced long-term functioning and well-being of children and youth with special healthcare needs (CYSHCN). Yet, there is a lack of recent evidence on the utilization of these services, and the age at which CYSHCN first receive them.

Objective: This study assessed the distribution, timing, and determinants of special services utilization across different types of special healthcare needs.

Methods: Data from 63,734 caregivers of CYSHCN aged 0-17 years from the 2016-2022 National Survey of Children's Health were analyzed using Rao-Scott Chi-Square, Log-rank, and Cox proportional hazard tests.

Results: Overall, 41.9 % of CYSHCN ever received special services, including 91.4 %, 90.3 %, 88.0, and 34.1 % of children and youth with Down syndrome, cerebral palsy, autism, and other special healthcare needs (OSHCN), respectively. Children with Down syndrome and cerebral palsy received special services earlier than those with autism or OSHCN. Utilization of special services was higher among male children and youth (aHR 1.41; 95 % CI: 1.33-1.49), aged 0-5 years (aHR: 4.70; 95 % CI: 4.32-5.11), second or later born children (aHR: 1.18; 95 % CI: 1.10-1.26), from families with low-income (aHR: 1.14; 95 % CI: 1.04-1.24), living with married parents (aHR: 1.11; 95 % CI: 1.04-1.19), consistently insured (aHR: 1.24; 95 % CI: 1.08-1.42), and with a more complex health condition (aHR: 3.40; 95 % CI: 3.13-3.70) compared to their counterparts.

Conclusions: These findings highlight the necessity of adopting tailored approaches for children with different special healthcare needs to optimize and sustain the utilization of special services.

有特殊医疗保健需求的儿童和青少年对特殊服务的利用情况:2016-2022 年全国儿童健康数据调查的时间到事件分析。
背景:包括物理、职业、言语或行为治疗在内的特殊服务与有特殊医疗保健需求的儿童和青少年(CYSHCN)的长期功能和福祉的提高息息相关。然而,关于这些服务的使用情况以及有特殊医疗需求的儿童和青少年首次接受这些服务的年龄,目前还缺乏最新的证据:本研究评估了不同类型有特殊医疗保健需求的儿童使用特殊服务的分布、时间和决定因素:采用 Rao-Scott Chi-Square 检验、Log-rank 检验和 Cox 比例危险检验分析了 2016-2022 年全国儿童健康调查中 63734 名 0-17 岁 CYSHCN 照料者的数据:总体而言,41.9%的CYSHCN曾经接受过特殊服务,其中患有唐氏综合征、脑瘫、自闭症和其他特殊医疗需求(OSHCN)的儿童和青少年分别占91.4%、90.3%、88.0%和34.1%。患有唐氏综合症和大脑性麻痹的儿童接受特殊服务的时间早于患有自闭症或有其他特殊医疗保健需求的儿童和青少年。男性儿童和青少年(aHR:1.41;95 % CI:1.33-1.49)、0-5 岁儿童(aHR:4.70;95 % CI:4.32-5.11)、第二胎或晚生儿童(aHR:1.18;95 % CI:1.10-1.26)、低收入家庭儿童(aHR:1.14;95 % CI:1.04-1.24)、与已婚父母同住(aHR:1.11;95 % CI:1.04-1.19)、持续投保(aHR:1.24;95 % CI:1.08-1.42)、健康状况更复杂(aHR:3.40;95 % CI:3.13-3.70):这些研究结果突出表明,有必要为有不同特殊医疗保健需求的儿童采取量身定制的方法,以优化和维持特殊服务的利用率。
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来源期刊
Disability and Health Journal
Disability and Health Journal HEALTH CARE SCIENCES & SERVICES-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
CiteScore
7.50
自引率
6.70%
发文量
134
审稿时长
34 days
期刊介绍: Disability and Health Journal is a scientific, scholarly, and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Topics may be related to global health, quality of life, and specific health conditions as they relate to disability. Such contributions include: • Reports of empirical research on the characteristics of persons with disabilities, environment, health outcomes, and determinants of health • Reports of empirical research on the Systematic or other evidence-based reviews and tightly conceived theoretical interpretations of research literature • Reports of empirical research on the Evaluative research on new interventions, technologies, and programs • Reports of empirical research on the Reports on issues or policies affecting the health and/or quality of life for persons with disabilities, using a scientific base.
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