Huang Zhihuan J, Kogan Michael D, Yu Stella M, Strickland Bonnie
Office of Data and Information Management, Maternal and Child Health Bureau/HRSA, 5600 Fishers Lane, Rockville, MD 20857, USA.
Ambul Pediatr. 2005 Jan-Feb;5(1):60-7. doi: 10.1367/A04-073R.1.
To examine the associations of sociodemographic characteristics with both the prevalence and the causes of delayed or forgone care in a nationally representative sample of children with special health care needs.
Data were abstracted from the 2001 National Survey of Children with Special Health Care Needs. The families of children with special health care needs (CSHCN) who reported delayed or forgone care were asked about the reasons. The 12 reasons in the questionnaire were grouped into 5 categories. Bivariate and multivariate logistic regression analyses were conducted in SUDAAN to examine the relationship between sociodemographic characteristics of CSHCN and the incidence of delayed or forgone care by its reasons.
Nearly 10% of CSHCN had experienced delayed or forgone health care in the past 12 months in 2001. Logistic regression showed that delayed or forgone care was more likely to be reported by the families of CSHCN who were adolescents, who had more severe limitations, lived in the South or West, lacked medical insurance, and who lived in families under or near the federal poverty line. Hispanics were more likely to report "lack of medical specialty" and "had language, communication, or cultural problems with provider." Both Hispanics and non-Hispanic others were twice as likely to report "provider not accessible" as reasons for the delayed or forgone care compared with non-Hispanic whites or blacks. conclusion: CSHCN with certain socioeconomic status and sociodemographic characteristics, as well as those with severe limitations in activity, were more likely to be affected by circumstances that result in delayed or forgone care.
在全国具有代表性的有特殊医疗需求儿童样本中，研究社会人口学特征与延迟或放弃医疗服务的患病率及原因之间的关联。
数据摘自2001年全国有特殊医疗需求儿童调查。对报告有延迟或放弃医疗服务的有特殊医疗需求儿童（CSHCN）的家庭询问原因。问卷中的12个原因分为5类。在SUDAAN中进行双变量和多变量逻辑回归分析，以研究CSHCN的社会人口学特征与其延迟或放弃医疗服务发生率按原因的关系。
2001年，近10%的CSHCN在过去12个月中经历过延迟或放弃医疗服务。逻辑回归显示，青少年、有更严重限制、居住在南部或西部、缺乏医疗保险以及生活在联邦贫困线以下或接近贫困线家庭的CSHCN家庭更有可能报告延迟或放弃医疗服务。西班牙裔更有可能报告“缺乏医学专科医生”和“与医疗服务提供者存在语言、沟通或文化问题”。与非西班牙裔白人或黑人相比，西班牙裔和其他非西班牙裔报告“无法获得医疗服务提供者”作为延迟或放弃医疗服务原因的可能性是其两倍。结论：具有特定社会经济地位和社会人口学特征的CSHCN，以及活动严重受限的CSHCN，更有可能受到导致延迟或放弃医疗服务情况的影响。
