Van Cleave Jeanne, Davis Matthew M
Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, Mass., USA.
Ambul Pediatr. 2008 Sep-Oct;8(5):305-11. doi: 10.1016/j.ambp.2008.04.003. Epub 2008 Jun 2.
To compare attendance at preventive medical and dental visits for children with special health care needs (CSHCN) and children without special health care needs, and associations between attending visits and unmet need.
We analyzed data on 102 353 children aged 0 to 17 years from the National Survey of Children's Health. We examined associations between attending preventive medical or dental visits and CSHCN status, and unmet need for medical or preventive dental care and attending preventive medical or dental visits.
Medical care-CSHCN were more likely than other children to attend a well-child visit (odds ratio [95% confidence interval], 1.45 [1.12-1.93] for 0 to 5 years, 1.99 [1.74-2.28] for 6 to 11 years, 1.84 [1.64-2.06] for 12 to 17 years). CSHCN aged 12 to 17 years attending a well-child visit had lower odds of unmet medical need (0.48 [0.27-0.85]) than CSHCN not attending visits; well-child visits and unmet need were not associated for younger age groups. Dental care-CSHCN aged 3 to 5 years were more likely than other children of similar ages to attend a preventive dental visit (1.26 [1.04-1.52]). CSHCN attending a preventive dental visit had lower odds of unmet preventive dental needs than CSHCN not attending visits (0.52 [0.28-0.93] for 3 to 5 years, 0.18 [0.12-0.28] for 6 to 11 years, 0.12 [0.08-0.17] for 12 to 17 years).
CSHCN attend preventive medical and dental visits at similar or higher rates than other children. CSHCN who attend visits are less likely to have unmet needs. Further research should examine differences in visit content for CSHCN and mechanisms whereby preventive care may reduce unmet need.
比较有特殊医疗需求儿童(CSHCN)和无特殊医疗需求儿童的预防性医疗和牙科就诊率,以及就诊与未满足需求之间的关联。
我们分析了来自全国儿童健康调查的102353名0至17岁儿童的数据。我们研究了进行预防性医疗或牙科就诊与CSHCN状态之间的关联,以及医疗或预防性牙科护理的未满足需求与进行预防性医疗或牙科就诊之间的关联。
有医疗需求的CSHCN比其他儿童更有可能进行健康儿童检查(0至5岁的比值比[95%置信区间]为1.45[1.12 - 1.93],6至11岁为1.99[1.74 - 2.28],12至17岁为1.84[1.64 - 2.06])。12至17岁进行健康儿童检查的CSHCN未满足医疗需求的几率(0.48[0.27 - 0.85])低于未进行检查的CSHCN;对于较年幼的年龄组,健康儿童检查与未满足需求之间无关联。牙科护理方面,3至5岁的CSHCN比其他同龄儿童更有可能进行预防性牙科就诊(1.26[1.04 - 1.52])。进行预防性牙科就诊的CSHCN未满足预防性牙科需求的几率低于未进行就诊的CSHCN(3至5岁为0.52[0.28 - 0.93],6至11岁为0.18[0.12 - 0.28],12至17岁为0.12[0.08 - 0.17])。
CSHCN进行预防性医疗和牙科就诊的比例与其他儿童相似或更高。进行就诊的CSHCN未满足需求的可能性较小。进一步的研究应检查CSHCN就诊内容的差异以及预防性护理可减少未满足需求的机制。