Analysis of Timely Access to Healthcare and Difficulty Procuring Specialist Care Among Children with and without Anxiety or Depression Disorders

Abstract

Background: To examine disparities to access preventive care and specialist care in children with anxiety or depression disorders. Methods: The population of interest was extracted from the National Survey of Children’s Health 2011/2012 (NSCH 2011/12) data set. The sample included children (0-17 years old) and their caregivers who completed the survey. Data were analyzed from February 2011 to June 2012. Outcome variables included reports for missed or delayed care, and problems procuring specialist care based on parental response to interview questions. Covariates included child/caregiver demographics, insurance status, household employment, and poverty levels. Findings: A total of 85 536 records were extracted from the NSCH 2011/12 data set. The covariate-adjusted odds (also adjusted as necessary using the correct sampling methods suggested by the NSCH) of having delayed or missed care for a child with anxiety or depression were 2.26 (95% confidence interval [CI], 1.83-2.79, p<0.001) times higher than a child without anxiety or depression. The covariate-adjusted odds of the caregiver reporting problems procuring specialist care for a child with anxiety or depression were 1.66 (95% CI, 1.45-1.88, p<0.001) times higher than a child without these diagnoses. Conclusions: Children with anxiety or depression are less likely to obtain timely preventive care and have problems procuring specialist care. These findings highlight a disparity that requires the attention of healthcare providers and outreach programs.