Barriers to care among US school-age children with disabilities

Objective: This study examined financial barriers to care experienced by families of US school-age children with disabilities.

Methods: We analyzed data collected through the 2005 National Health Interview Survey. Children (ages 5-17) were categorized into four health condition groups: reported activity limitations, disabling conditions without activity limitations, chronic asthma and no health conditions. Financial barriers to care were defined as being unable to afford prescriptions or having delayed/foregone medical care because of cost during the previous 12 months. These were examined according to insurance coverage and poverty level for each health condition group. Logistic regression analysis was conducted to determine predictors of financial barriers to care.

Results: Privately insured children with activity limitations were significantly more likely than privately insured children with no health conditions to delay medical care (6.32% vs. 1.63%) or be unable to afford prescriptions (5.32% vs. 1.12%). Of children living at or above 200% FPL, children with activity limitations were significantly more likely to have all three financial barriers to care than children with no health conditions. In multivariate analysis, being uninsured, ages 14-17, living in the Midwest, a family income below 200% FPL, and having an activity limitation were significant predictors for financial barriers to care.

Conclusions: Children with activity limitations are more likely to have financial barriers to care compared to other children. Uninsured and privately insured children with activity limitations are significantly more likely to experience these barriers.