title: Comparison between hospital-based and community-based services for the special health care needs of children with developmental delays.
abstract: BACKGROUND
  Recognizing special health care needs (SHCN) is obligatory for children with developmental delay (DD). The purpose of this study was to compare hospital-based and community-based services for the SHCN of children with DD.
  
  
  METHODS
  We collected 114 children with DD. An expert-designed questionnaire was used to measure the SHCN of children in either hospital-based or community-based services. The questionnaire included the children's characteristics, family ecology and SHCN, which encompassed four categories, team assessment and counseling, rehabilitation, complementary and alternative treatment, and home care. We compared the differences and needs between the two health care services.
  
  
  RESULTS
  More children with DD in hospital-based services had disabled certificates, catastrophic illness certificates and multiple caregivers than community based services. More children with DD in community-based services had severe-disabled certificates than those in hospital-based services (p < 0.001). Children in hospital-based services had more SHCN for some items of team assessment and counseling, rehabilitation, and complementary and alternative treatment than those in community-based services (p < 0.05). The need for home care was not significantly different between the two services except for nutrition counseling (p = 0.048).
  
  
  CONCLUSIONS
  SHCN in multiple aspects imply the necessity for team assessment and counseling, rehabilitation, complementary and alternative treatments and nutrition counseling in approaching children with DD in hospital-based services.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Jannie Ying-Syuan
authors.initials: JY
authors.lastname: Chen
authors.forename: Keh-Chung
authors.initials: KC
authors.lastname: Lin
authors.forename: Chung-Yao Chen
authors.initials: CY
authors.lastname: Chen
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Liu
authors.forename: Mei-Yun
authors.initials: MY
authors.lastname: Liaw
authors.forename: Ching-Y
authors.initials: CY
authors.lastname: Wu
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Hsu
mesh_terms: D002648:Child; D003153:Community Health Services; D002658:Developmental Disabilities / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D010044:Outpatient Clinics, Hospital