 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jane Anyasa Otado, PhD1, Patricia N. Pastor, PhD2, Kenneth C. Schoendorf, MD, MPH1, and Jennifer D. Parker, PhD3. (1) Office of Analysis, Epidemiology and Health Promotion, Infant and Child Health Studies Branch, Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Rd., Rm 6106, Hyattsville, MD 20782, 301-458-4259, jjo1@cdc.gov, (2) Population Epidemiology Branch, Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, (3) Population Epidemiology Branch, Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782
Children with chronic medical conditions require more health care than those without conditions. Even with health insurance, children with chronic medical conditions may experience barriers to care. We describe parental reporting of perceived barriers to health care among three groups of children: those with asthma and no other reported medical or developmental/cognitive conditions; those with reported developmental and cognitive conditions (i.e., learning disability, attention deficit, mental retardation, other developmental delays) and no other reported medical condition; those without any chronic medical or developmental/cognitive conditions. Data on perceived financial barriers (e.g., care delayed for economic considerations) and non-financial barriers (e.g., unable to make appointment) to health care; insurance coverage (e.g., private, Medicaid, none); and demographic characteristics were collected for 23,217 children 6-17 years of age in the 1998-2000 National Interview Health Surveys. We compared perceived health care barriers between the three groups of children and examined the influence of insurance on those barriers. Children with chronic medical conditions reported more financial barriers compared to children without these conditions (asthma=12%, developmental=17%, none=8.7%). Adjustment for insurance and demographic factors did not change those results. As expected, among uninsured children in each group, financial barriers to care were substantially more common (asthma=34.8%, developmental= 46.8%, none= 26.5%). Non-financial barriers were also more common among children with chronic conditions (asthma=9.9%, developmental=9.5%, none=6.8%). Among children with Medicaid, the highest levels of non-financial barriers were reported for children with asthma. Nineteen percent of children with asthma receiving Medicaid reported non-financial barriers versus 13 percent of children with developmental/cognitive conditions receiving Medicaid. Barriers to necessary care are more common among children with chronic medical conditions, even among those with insurance. In particular, children with chronic medical conditions who receive Medicaid are at substantial risk of barriers to care. Addressing those barriers is important to assure that children most in need of care are able to receive it.
Learning Objectives:
Keywords: Children With Special Needs, Barriers to Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.