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具有神经疾病的儿童期慢性病患者的未满足医疗需求。

Unmet health care needs among CSHCN with neurologic conditions.

机构信息

Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, 1600 Clifton Rd, Atlanta, GA 30333, USA.

出版信息

Pediatrics. 2009 Dec;124 Suppl 4:S343-51. doi: 10.1542/peds.2009-1255D.

Abstract

OBJECTIVE

Children with neurologic conditions require a variety of services. With this study we examined health care needs and unmet needs among children with neurologic conditions.

METHODS

Cross-sectional data reported by parents of 3- to 17-year-olds in the 2005-2006 National Survey of Children With Special Health Care Needs were analyzed. Demographic characteristics, health care needs, and unmet needs of children with special health care needs (CSHCN) and neurologic conditions were descriptively compared with an independent referent group of children without special health care needs; statistical contrasts were performed as a function of the type (conditions included in the Diagnostic and Statistical Manual of Mental Disorders [DSM] or not) and number of reported neurologic conditions.

RESULTS

Compared with the parents of children without special health care needs, parents of CSHCN with neurologic conditions were more likely to report unmet health care needs for their child. After adjustment for demographic factors and severity of functional limitation, CSHCN with at least 2 conditions had more visits to a health care provider, needed more services, and reported more unmet needs than CSHCN with a single DSM condition. The magnitude of need among CSHCN was greatest among those with at least 1 of each type of neurologic condition.

CONCLUSIONS

Unmet health care needs exist among CSHCN with neurologic conditions and are particularly pronounced among children with a combination of both DSM and non-DSM disorders. The health care needs among CSHCN with multiple neurologic conditions may be better served by targeted efforts to improve care coordination.

摘要

目的

患有神经系统疾病的儿童需要各种服务。本研究旨在检查患有神经系统疾病儿童的医疗保健需求和未满足需求。

方法

对 2005-2006 年全国特殊健康需求儿童调查中 3 至 17 岁儿童家长报告的横断面数据进行分析。描述性比较有特殊健康需求的儿童(CSHCN)和神经系统疾病儿童的特殊健康需求、未满足需求与无特殊健康需求的独立参照组儿童的差异;根据报告的神经系统疾病的类型(是否包括《精神障碍诊断与统计手册》[DSM]中的疾病)和数量进行统计对比。

结果

与无特殊健康需求儿童的家长相比,患有神经系统疾病的 CSHCN 的家长更有可能报告其子女存在未满足的医疗保健需求。在调整人口统计学因素和功能限制严重程度后,至少有 2 种疾病的 CSHCN 比仅有单一 DSM 疾病的 CSHCN 更有可能去看医疗保健提供者、需要更多服务、并报告更多未满足的需求。在每种类型的神经系统疾病中至少有一种疾病的 CSHCN 的需求程度最大。

结论

患有神经系统疾病的 CSHCN 存在未满足的医疗保健需求,其中同时患有 DSM 和非 DSM 障碍的儿童需求更为突出。针对患有多种神经系统疾病的 CSHCN 的医疗保健需求,可以通过有针对性的努力来改善护理协调来更好地满足。

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