title: Health insurance and utilization of medical care for children with special health care needs.
abstract: Based on analyses of the 1988 National Center for Health Statistics, National Health Interview Survey, Child Health Supplement, this study examines the insurance coverage and utilization of physicians, hospitals, and prescribed medicine among the 9.6 million U.S. children with special health care needs, defined as children who had one or more selected chronic conditions that caused them to experience pain, discomfort, or being upset often or all of the time in the last year, or who were limited in their major childhood activities (playing or going to school) as a result of these or other impairments or health problems. The findings confirmed that substantial variation in access to routine medical care exists among these children. Though health status is an important predictor of which children use services in general, poor, minority children who lived with their mother or someone other than their parents, or those without insurance or an identifiable regular medical provider were most likely to experience financial barriers to access or were less apt to seek care than other children with comparable needs. Access to routine medical care remains particularly problematic for these subsets of children with special health care needs.
authors.affiliation: University of Texas School of Public Health, Houston 77225.
authors.forename: L A
authors.initials: LA
authors.lastname: Aday
authors.forename: E S
authors.initials: ES
authors.lastname: Lee
authors.forename: B
authors.initials: B
authors.lastname: Spears
authors.forename: C W
authors.initials: CW
authors.lastname: Chung
authors.forename: A
authors.initials: A
authors.lastname: Youssef
authors.forename: B
authors.initials: B
authors.lastname: Bloom
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D011307:Drug Prescriptions; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data; D009309:National Center for Health Statistics, U.S.; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology