Differences in risk factors for children with special health care needs (CSHCN) receiving needed specialty care by Socioeconomic Status.
BACKGROUND
The purpose of this study is to identify factors affecting CSHCN's receiving needed specialty care among different socioeconomic levels. Previous literature has shown that Socioeconomic Status (SES) is a significant factor in CHSHCN receiving access to healthcare. Other literature has shown that factors of insurance, family size, race/ethnicity and sex also have effects on these children's receipt of care. However, this literature does not address whether other factors such as maternal education, geographic location, age, insurance type, severity of condition, or race/ethnicity have different effects on receiving needed specialty care for children in each SES level.


METHODS
Data were obtained from the National Survey of Children with Special Health Care Needs, 2000-2002. The study analyzed the survey which studies whether CHSCN who needed specialty care received it. The analysis included demographic characteristics, geographical location of household, severity of condition, and social factors. Multiple logistic regression models were constructed for SES levels defined by federal poverty level: < 199%; 200-299%; >or= 300%.


RESULTS
For the poorest children (,199% FPL) being uninsured had a strong negative effect on receiving all needed specialty care. Being Hispanic was a protective factor. Having more than one adult in the household had a positive impact on receipt of needed specialty care but a larger number of children in the family had a negative impact. For the middle income group of children (200-299% of FPL severity of condition had a strong negative association with receipt of needed specialty care. Children in highest income group (> 300% FPL) were positively impacted by living in the Midwest and were negatively impacted by the mother having only some college compared to a four-year degree.


CONCLUSIONS
Factors affecting CSHCN receiving all needed specialty care differed among socioeconomic groups. These differences should be addressed in policy and practice. Future research should explore the CSHCN population by income groups to better serve this population.
Lykens
Kristine A
KA
Department of Health Management and Policy, University of North, Texas Health Science Center, School of Public Health, Forth Worth, TX, USA. klykens@hsc.unt.edu
Fulda
Kimberly G
KG
Bae
Sejong
S
Singh
Karan P
KP
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D008511:Medicine; D012923:Social Class; D013038:Specialization; D014481:United States