Department of Health Management and Policy, University of New Hampshire, Durham, NH 03824, USA.
J Pediatr. 2011 Oct;159(4):535-40.e2. doi: 10.1016/j.jpeds.2011.04.019. Epub 2011 Jun 12.
To measure the co-morbidities associated with Down syndrome compared with those in other children with special health care needs (CSHCN). Additionally, to examine reported access to care, family impact, and unmet needs for children with Down syndrome compared with other CSHCN.
An analysis was conducted on the nationally representative 2005 to 2006 National Survey of Children with Special Health Care Needs. Bivariate analyses compared children with Down syndrome with all other CSHCN. Multivariate analyses examined the role of demographic, socioeconomic, and medical factors on measures of care receipt and family impact.
An estimated 98,000 CSHCN have Down syndrome nationally. Compared with other CSHCN, children with Down syndrome had a greater number of co-morbid conditions, were more likely to have unmet needs, faced greater family impacts, and were less likely to have access to a medical home. These differences become more pronounced for children without insurance and from low socioeconomic status families.
Children with Down syndrome disproportionately face greater disease burden, more negatively pronounced family impacts, and greater unmet needs than other CSHCN. Promoting medical homes at the practice level and use of those services by children with Down syndrome and other CSHCN may help mitigate these family impacts.
与其他有特殊医疗需求的儿童（CSHCN）相比，测量唐氏综合征相关的合并症。此外，比较唐氏综合征患儿与其他 CSHCN 报告的获得医疗照顾情况、家庭影响和未满足的需求。
对具有全国代表性的 2005 年至 2006 年全国特殊健康需求儿童调查进行了分析。双变量分析比较了唐氏综合征患儿与所有其他 CSHCN。多变量分析考察了人口统计学、社会经济和医疗因素对医疗服务获得和家庭影响的衡量作用。
全国估计有 9.8 万名 CSHCN 患有唐氏综合征。与其他 CSHCN 相比，唐氏综合征患儿有更多的合并症，未满足的需求更多，家庭影响更大，获得医疗之家的机会更少。对于没有保险和来自社会经济地位较低家庭的儿童，这些差异更为明显。
唐氏综合征患儿比其他 CSHCN 面临更大的疾病负担、更严重的家庭影响和更多的未满足需求。在实践层面促进医疗之家的建立，并让唐氏综合征患儿和其他 CSHCN 使用这些服务，可能有助于减轻这些家庭影响。
