Preventive health care for children with and without special health care needs.
OBJECTIVE
The objective of this study was to compare the receipt of preventive health services for children with and without special health care needs and to identify predictors of these health services for children with special health care needs using nationally representative data.


METHODS
Data from the 2002 and 2003 Medical Expenditure Panel Surveys were analyzed. A total of 18,279 children aged 3 to 17 years were included in our study. The Child Preventive Health Supplement was used to identify caregiver recall of specific health screening measures and anticipatory guidance during the previous 12 months. Odds ratios were calculated for predictive factors of preventive services for children with special health care needs.


RESULTS
The prevalence of special health care needs in children aged 3 to 17 years was 21.6%. Based on caregiver reports, 87.5% of children with special health care needs had > or = 1 health screening measure checked in the past year compared with 73.1% of children without special health care needs. Receipt of > or = 1 topic of anticipatory guidance was reported for 69.8% of children with special health care needs compared with 55.2% of children without special health care needs. Black and Hispanic caregivers of children with special health care needs were more likely than others to report receipt of all 6 categories of anticipatory guidance measured in this study.


CONCLUSIONS
We found that caregivers of children with special health care needs were more likely to report receipt of anticipatory guidance and health screening than were caregivers of children without special health care needs. Although a majority of these caregivers reported receiving some health screening and anticipatory guidance on an annual basis, there are clear gaps in the delivery of preventive health services. This study identifies areas for improvement in the delivery of preventive health services for children with special health care needs and children in general.
Houtrow
Amy J
AJ
Department of Pediatrics, University of California at San Francisco, San Francisco, California, USA. houtrowa@peds.ucsf.edu
Kim
Sue E
SE
Chen
Alex Y
AY
Newacheck
Paul W
PW
D000293:Adolescent; D002140:California; D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000639:trends; D002669:Child Welfare; D002675:Child, Preschool; D016001:Confidence Intervals; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D020380:Needs Assessment; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010372:Pediatrics / Q000592:standards / Q000639:trends; D015995:Prevalence; D011315:Preventive Medicine / Q000592:standards* / Q000639:trends; D012016:Reference Values; D018570:Risk Assessment; D012959:Socioeconomic Factors