265461 Impact of Health Care Related Financial Burden on Unmet Need among Children with Special Health Care Needs

Monday, October 29, 2012 : 4:53 PM - 5:11 PM

Lauren E. Wisk, BS , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Families of children with special health care needs (CSHCN) are particularly vulnerable to experiencing elevated financial burden as a result of high health care utilization. We sought to determine how subjective and objective health care related financial burden are related to delayed or forgone care for CSHCN, using a nationally representative, population-based sample. We examined data on 36,187 CSHCN from the 2005-2006 National Survey of Children with Special Health Care Needs. Subjective financial burden was defined by self-report that the reference child's health care caused financial problems for their family. Objective, absolute financial burden was defined as the reported amount the family paid for the reference child's health care over the past 12 months. Objective, relative financial burden was defined as self-report of needing any additional income to cover the reference child's health care expenses. Delayed or forgone care was defined as self-report of delayed or forgone needed health care for the reference child during the past 12 months. Experiencing subjective financial burden (OR 1.93, 95% CI: 1.74-2.15) and objective relative financial burden (OR 1.90, 95% CI: 1.70-2.12) were both independently associated with increased odds of experiencing delayed or forgone care, adjusting for other relevant sociodemographic characteristics. Subjective and objective, relative financial burden are both strong, independent predictors of delayed or forgone care for CSHCN. To prevent unmet need for this vulnerable population, policy changes targeted at alleviating relative burden, such as implementing income adjusted cost-sharing, may be more effective than policies that address absolute burden.

Learning Areas:
Advocacy for health and health education
Provision of health care to the public
Public health or related research

Learning Objectives:
Discuss the contribution of subjective and objective financial burden to unmet healthcare need for children with special healthcare needs.

Keywords: Access to Care, Children's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived the research question, compiled the data, and conducted all analyses for this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.