Nageswaran Savithri
Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Arch Pediatr Adolesc Med. 2009 Jan;163(1):49-54. doi: 10.1001/archpediatrics.2008.504.
To describe (1) the subpopulation of children with special health care needs (CSHCN) in need of respite care and (2) the factors associated with unmet respite care needs.
Cross-sectional study using the 2001 National Survey of Children With Special Health Care Needs.
The United States.
Caregivers of CSHCN.
We determined the association of sociodemographic factors and health status of CSHCN with need for respite care and unmet needs for respite care.
Of the 38 831 respondents, 3178 (8.8%) reported need for respite care in the prior 12 months. The CSHCN who were young and uninsured/had insurance gaps or had public insurance and those with functional limitations and unstable health conditions were more likely to need respite care. Twenty-four percent of CSHCN who needed respite care did not receive such services. In multivariate analysis, higher maternal education (adjusted odds ratio [AOR], 1.6 for more than high school education compared with high school education or less), some and severe functional limitations (AORs, 2.5 and 5.6, respectively, compared with no limitation), and unstable health condition (AOR, 2.3 compared with stable condition) were associated with greater unmet respite care needs. The CSHCN with public insurance were half as likely and CSHCN with private insurance were as likely to report unmet respite care needs as those who were uninsured/with insurance gaps.
Respite care needs of CSHCN are frequently unmet. Furthermore, strategies are needed to improve access to respite care for families of CSHCN.
描述(1)需要喘息服务的有特殊医疗需求儿童(CSHCN)亚群体,以及(2)与未满足的喘息服务需求相关的因素。
采用2001年全国有特殊医疗需求儿童调查的横断面研究。
美国。
CSHCN的照料者。
我们确定了CSHCN的社会人口统计学因素和健康状况与喘息服务需求及未满足的喘息服务需求之间的关联。
在38831名受访者中,3178人(8.8%)报告在过去12个月中有喘息服务需求。年龄较小、未参保/有保险缺口或有公共保险的CSHCN,以及有功能限制和健康状况不稳定的CSHCN更有可能需要喘息服务。需要喘息服务的CSHCN中有24%未获得此类服务。在多变量分析中,母亲受教育程度较高(与高中及以下学历相比,高中以上学历的调整优势比[AOR]为1.6)、有一些和严重功能限制(与无限制相比,AOR分别为2.5和5.6)以及健康状况不稳定(与稳定状况相比,AOR为2.3)与更大的未满足的喘息服务需求相关。有公共保险的CSHCN报告未满足的喘息服务需求的可能性是未参保/有保险缺口者的一半,有私人保险的CSHCN报告未满足的喘息服务需求的可能性与未参保/有保险缺口者相同。
CSHCN的喘息服务需求经常得不到满足。此外,需要采取策略来改善CSHCN家庭获得喘息服务的机会。