title: Differentiating subgroups of children with special health care needs by health status and complexity of health care needs.
abstract: OBJECTIVE
  Our objective is to use the Children with Special Health Care Needs (CSHCN) Screener to identify subgroups of CSHCN differentiated by health status and complexity of need.
  
  
  METHODS
  Data are from the National Survey of Children with Special Health Care Needs, 2001 and the National Survey of Children's Health, 2003 (conducted by the Maternal and Child Health Bureau and the National Center for Health Statistics); and the 2001 and 2002 Medical Expenditure Panel Survey, conducted by the Agency for Healthcare Research and Quality. A broad array of variables measuring health status, complexity of need, and related issues are examined by subgroupings of CSHCN.
  
  
  RESULTS
  Relative to other CSHCN, CSHCN with functional limitations or who qualify on more CSHCN Screener items have poorer health status and more complex health care needs. They more often experience a variety of health issues; their insurance is more often inadequate; the impact of their conditions on their families is higher; and their medical costs are higher.
  
  
  CONCLUSIONS
  In the absence of information on specific conditions, health status, or complexity of need, the CSHCN Screener alone can be used to create useful analytic subgroups that differ on these dimensions. The proposed subgroups, based on the type or number of CSHCN screening criteria, differentiate CSHCN by health status and complexity of health care needs, and also show differences in the impact of their conditions on their families, costs of their medical care, and prevalence of various health problems.
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. MBramlett@cdc.gov
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Bramlett
authors.forename: Debra
authors.initials: D
authors.lastname: Read
authors.forename: Christina
authors.initials: C
authors.lastname: Bethell
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D019988:Children with Disabilities; D006301:Health Services Needs and Demand / Q000145:classification*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D011795:Surveys and Questionnaires