title: Do children with developmental disabilities and mental health conditions have greater difficulty using health services than children with physical disorders?
abstract: The objective of this study is to determine whether achievement of the Maternal and Child Health Bureau core outcome ease of use of health services differs between children with developmental disabilities, mental health conditions and physical disorders. We analyzed data from the 2005 National Survey of Children with Special Health Care Needs. Children with special health care needs were classified into 4 health condition groups: developmental disabilities (DD), mental health conditions (MH), physical disorders (PD) and multiple conditions. The outcome measure was 'difficulty using services'. We conducted bivariate and multivariate analyses to determine the associations between the health condition groups and the outcome. Of the CSHCN included in the study, 2.6% had DD, 12.9% had MH, 49.9% had PD and 34.6% belonged to multiple conditions group. Four percent of CSHCN with PD, 17% of those with DD, 13% of those with MH and 20% of those in the multiple conditions group had difficulty using services. In multivariate analyses, CSHCN with DD had 2.3 times and MH conditions had 2.6 times the odds of having difficulty using services compared to those with PD. Existing programs for CSHCN should be evaluated for the adequacy of services provided to children with DD and MH. Future studies should evaluate how developmental disabilities and mental health policies affect navigating the health care system for this population.
authors.affiliation: Department of Pediatrics, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. snageswa@wfubmc.edu
authors.forename: Savithri
authors.initials: S
authors.lastname: Nageswaran
authors.forename: Susan L
authors.initials: SL
authors.lastname: Parish
authors.forename: Roderick A
authors.initials: RA
authors.lastname: Rose
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Grady
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002669:Child Welfare; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities; D019988:Children with Disabilities / Q000534:rehabilitation / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008297:Male; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D001523:Mental Disorders; D015999:Multivariate Analysis; D016017:Odds Ratio; D014481:United States