Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103265

Kristen Hill, MPH, Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, 50 Staniford Street, Suite 901, Boston, MA 02114, 617-726-1885, kshill@partners.org, Recai Yucel, PhD, Department of Biostatistics and Epidemiology, University of Massachusetts-Amherst School of Public Health, 715 North Pleasant Street, Amherst, MA 01003, and Karen Kuhlthau, PhD, Massachusetts General Hospital for Children, Center for Child and Adolescent Health Policy, Harvard University, School of Medicine, 50 Staniford Street, Suite 901, Boston, MA 02114.

Background: The 2001 revised ICF and the 1998 MCHB definition of children with special health care needs (CSHCN) provide 2 similar but distinct theoretical frameworks for identifying children using a non-categorical approach. Knowing which children are identified through different definitions is important to policy, planning and future research.

Objective: To compare definitions based on the ICF, the CSHCN Screener (Screener), and a synthetic screener using the Medical Expenditure Panel Survey (MEPS).

Methods: In 2000, MEPS has a unique overlap of child health questions including: ICF related questions about activity and participation, the Screener, and utilization and need variables which we mapped to the Screener for use as a proxy in earlier years. We compare characteristics of children identified through these frameworks and consider the implications of the changes in MEPS for analyses using the ICF framework.

Results: Using 2000 data we identify 9% of children with a functional limitation; of those 57% are identified through the Screener. The Screener identifies 16% of children and 14% are identified through our synthetic screener. Twelve percent of all children have discordant responses to these two questions.

Conclusion: In future years of MEPS, when the limitation questions are omitted, these analyses show that the Screener would identify a much broader population than these ICF-related questions. We further find that approximating the CSHCN Screener using utilization and need is only a rough approximation of the Screener. Analyses looking across years of MEPS will need to proceed with caution as the ability to identify children changes.

Learning Objectives: As a result of this presentation, participants will

• Discuss how the International Classification of Functioning, Disability and Health (ICF) and the Maternal and Child Heath Bureau’s definition for children with special health care needs (CSHCN) compare and how they differ.
• Briefly explain the development and limitations of mapping a variety of utilization, need, functional limitation and diagnostic information variables from the Medical Expenditure Panel Survey to the CSHCN Screener.
• Describe the differences in the population of children identified by 3 different frameworks (the ICF, the CSHCN Screener and a synthetic screener) and the implications for future research and policy.

Keywords: Children With Special Needs, Disability

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation