title: Inequities in health care needs for children with medical complexity.
abstract: Children with special health care needs are believed to be susceptible to inequities in health and health care access. Within the group with special needs, there is a smaller group of children with medical complexity: children who require medical services beyond what is typically required by children with special health care needs. We describe health care inequities for the children with medical complexity compared to children with special health care needs but without medical complexity, based on a secondary analysis of data from the 2005-06 and 2009-10 National Survey of Children with Special Health Care Needs. The survey examines the prevalence, health care service use, and needs of children and youth with special care needs, as reported by their families. The inequities we examined were those based on race/ethnicity, primary language in the household, insurance type, and poverty status. We found that children with medical complexity were twice as likely to have at least one unmet need, compared to children without medical complexity. Among the children with medical complexity, unmet need was not associated with primary language, income level, or having Medicaid. We conclude that medical complexity itself can be a primary determinant of unmet needs.
authors.affiliation: Dennis Z. Kuo (dzkuo@uams.edu) is an associate professor of pediatrics at the University of Arkansas for Medical Sciences, in Little Rock.
authors.forename: Dennis Z
authors.initials: DZ
authors.lastname: Kuo
authors.affiliation: Anthony Goudie is an assistant professor of pediatrics at the University of Arkansas for Medical Sciences.
authors.forename: Anthony
authors.initials: A
authors.lastname: Goudie
authors.affiliation: Eyal Cohen is an associate professor of pediatrics at the Hospital for Sick Children and University of Toronto, in Ontario.
authors.forename: Eyal
authors.initials: E
authors.lastname: Cohen
authors.affiliation: Amy Houtrow is an associate professor of pediatric and physical medicine and rehabilitation medicine at the University of Pittsburgh, in Pennsylvania.
authors.forename: Amy
authors.initials: A
authors.lastname: Houtrow
authors.affiliation: Rishi Agrawal is an assistant professor of pediatrics at the Ann and Robert H. Lurie Children's Hospital and the Northwestern University Feinberg School of Medicine, both in Chicago, Illinois.
authors.forename: Rishi
authors.initials: R
authors.lastname: Agrawal
authors.affiliation: Adam C. Carle is an associate professor of pediatrics at Cincinnati Children's Hospital Medical Center and the University of Cincinnati, in Ohio.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Carle
authors.affiliation: Nora Wells is the executive director of Family Voices, Inc., working in Lexington, Massachusetts.
authors.forename: Nora
authors.initials: N
authors.lastname: Wells
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020380:Needs Assessment; D014481:United States
keywords: Children’s Health; Chronic Care; Disparities; Maternal And Child Health