Unmet health care needs among CSHCN with neurologic conditions

• Published in: Pediatrics (Evanston) Vol. 124 Suppl 4; p. S343
• Main Authors: Bitsko, Rebecca H, Visser, Susanna N, Schieve, Laura A, Ross, Danielle S, Thurman, David J, Perou, Ruth
• Format: Journal Article
• Language: English
• Published: United States 01.12.2009
• Subjects: Adolescent; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - therapy; Autistic Disorder - epidemiology; Autistic Disorder - therapy; Child; Child Health Services - utilization; Child, Preschool; Comorbidity; Cross-Sectional Studies; Down Syndrome - epidemiology; Down Syndrome - therapy; Epilepsy - epidemiology; Epilepsy - therapy; Health Services Accessibility - statistics & numerical data; Health Services Needs and Demand - statistics & numerical data; Health Surveys; Humans; Needs Assessment; Nervous System Diseases - epidemiology; Nervous System Diseases - therapy; Prevalence; United States - epidemiology; United States
• DOI: 10.1542/peds.2009-1255D

Children with neurologic conditions require a variety of services. With this study we examined health care needs and unmet needs among children with neurologic conditions. Cross-sectional data reported by parents of 3- to 17-year-olds in the 2005-2006 National Survey of Children With Special Health Care Needs were analyzed. Demographic characteristics, health care needs, and unmet needs of children with special health care needs (CSHCN) and neurologic conditions were descriptively compared with an independent referent group of children without special health care needs; statistical contrasts were performed as a function of the type (conditions included in the Diagnostic and Statistical Manual of Mental Disorders [DSM] or not) and number of reported neurologic conditions. Compared with the parents of children without special health care needs, parents of CSHCN with neurologic conditions were more likely to report unmet health care needs for their child. After adjustment for demographic factors and severity of functional limitation, CSHCN with at least 2 conditions had more visits to a health care provider, needed more services, and reported more unmet needs than CSHCN with a single DSM condition. The magnitude of need among CSHCN was greatest among those with at least 1 of each type of neurologic condition. Unmet health care needs exist among CSHCN with neurologic conditions and are particularly pronounced among children with a combination of both DSM and non-DSM disorders. The health care needs among CSHCN with multiple neurologic conditions may be better served by targeted efforts to improve care coordination.