Porterfield Shirley L, McBride Timothy D
School of Social Work, University of Missouri-St Louis, St Louis, MO 63121, USA.
Am J Public Health. 2007 Feb;97(2):323-9. doi: 10.2105/AJPH.2004.055921. Epub 2006 Dec 28.
We examined the association between several variables and the use of specialist physician services, developmental therapies, and prescription medications among children with special health care needs (N=38866).
We used a bivariate probit model to estimate whether a given child needed specialized services and whether that child accessed those services; we controlled for activity limitations and severity of special needs. Variables included family income, mother's (or other caregiver's) educational level, health insurance coverage, and perceived need for specialized services. We used data from the 2001 National Survey of Children with Special Health Care Needs.
Lower-income and less-educated parents were less likely than higher-income and more-educated parents to say their special needs children needed specialized health services. The probability of accessing specialized health services-when needed-increased with both higher family income and insurance coverage.
Children with special health care needs have less access to health services because their parents do not recognize the need for those services. An intervention in the form of information at the family level may be an appropriate policy response.
我们研究了几个变量与有特殊医疗需求儿童（N = 38866）使用专科医生服务、发育疗法和处方药之间的关联。
我们使用双变量概率模型来估计某个特定儿童是否需要专科服务以及该儿童是否能获得这些服务；我们控制了活动受限情况和特殊需求的严重程度。变量包括家庭收入、母亲（或其他照料者）的教育水平、医疗保险覆盖范围以及对专科服务的感知需求。我们使用了2001年全国有特殊医疗需求儿童调查的数据。
与高收入和高学历的父母相比，低收入和低学历的父母表示他们有特殊需求的孩子需要专科医疗服务的可能性更小。在有需求时获得专科医疗服务的概率会随着家庭收入和保险覆盖范围的增加而提高。
有特殊医疗需求的儿童获得医疗服务的机会较少，因为他们的父母没有认识到对这些服务的需求。以家庭层面信息提供为形式的干预措施可能是一种合适的政策应对方式。
