title: Barriers to care for children and youth with special health care needs: perceptions of Illinois pediatricians.
abstract: OBJECTIVE. To assess primary care pediatricians' (PCPs') perceptions of caring for children and youth with special health care needs (CYSHCN). METHODS. Cross-sectional survey of Illinois pediatricians. RESULTS. Thirty-five percent of surveys were returned and 26% were analyzed. The top 3 perceived barriers were insufficient time (72%), insufficient reimbursement (68%), and lack of support services (59%). Insufficient interest was the least cited barrier (19%). Preparedness to perform tasks related to care of CYSHCN ranged from 89% for accessing early intervention services to 24% for billing and coding. The percentage of PCPs somewhat or very comfortable providing primary care to patients with technology dependence ranged from 75% for blood glucose monitoring to 12% for dialysis. CONCLUSIONS. The issues of time, reimbursement, billing, and coding are perceived as significant barriers to the care CYSHCN. There is substantial variation in PCPs' comfort in the care of CYSHCN who require the assistance of medical technologies.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Agrawal
authors.forename: Parag
authors.initials: P
authors.lastname: Shah
authors.forename: Kathy
authors.initials: K
authors.lastname: Zebracki
authors.forename: Kathy
authors.initials: K
authors.lastname: Sanabria
authors.forename: Claire
authors.initials: C
authors.lastname: Kohrman
authors.forename: Arthur F
authors.initials: AF
authors.lastname: Kohrman
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007087:Illinois; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care; D011795:Surveys and Questionnaires