Vanderbilt University School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Ste 600, Nashville, TN 37203-1738, United States.
Res Dev Disabil. 2011 Nov-Dec;32(6):2714-23. doi: 10.1016/j.ridd.2011.05.040. Epub 2011 Jun 25.
Children with potentially severe health conditions such as cerebral palsy (CP) are at risk for unmet health care needs. We sought to determine whether children with CP had significantly greater unmet health care needs than children with other special health care needs (SHCN), and whether conditions associated with CP increased the odds of unmet health care needs. We analyzed data from the National Survey of Children with Special Health Care Needs, 2005-2006, using multivariate logistic regression to calculate the adjusted odds of children with CP having one or more unmet health care needs compared to children with other SHCN. We also determined the association of CP-related conditions with unmet health care needs in children with CP. After weighting to national averages, our sample represented 178,536 children with CP (1.9%), and 9,236,794 with children with other SHCN (98.1%). Although having CP increased the odds that children had unmet health care needs (OR = 1.46, 95% CI [1.07-1.99]), the presence of a "severe" health condition weakened the association. Gastrointestinal problems and emotional problems increased the odds that children with CP would have unmet health care needs above that of children without the associated conditions (p ≤ .01). Children with CP are similar to children with other SHCN and may benefit from collaborative programs targeting severe chronic conditions. However, children with CP and associated conditions have increased odds of unmet health care needs in comparison to children without those problems.
患有脑瘫(CP)等潜在严重健康问题的儿童存在未满足的医疗保健需求。我们旨在确定 CP 患儿是否比其他特殊健康需求儿童(SHCN)更有可能存在未满足的医疗保健需求,以及与 CP 相关的疾病是否会增加未满足医疗保健需求的几率。我们分析了 2005-2006 年全国特殊健康需求儿童调查的数据,使用多变量逻辑回归来计算 CP 患儿与其他 SHCN 患儿相比,存在一个或多个未满足医疗保健需求的调整后几率。我们还确定了 CP 相关疾病与 CP 患儿未满足医疗保健需求之间的关系。经过加权以达到全国平均值,我们的样本代表了 178536 名 CP 患儿(1.9%)和 9236794 名其他 SHCN 患儿(98.1%)。尽管 CP 增加了儿童存在未满足医疗保健需求的几率(OR=1.46,95%CI[1.07-1.99]),但严重疾病的存在削弱了这种关联。胃肠道问题和情绪问题增加了 CP 患儿存在未满足医疗保健需求的几率,高于没有相关疾病的患儿(p≤0.01)。CP 患儿与其他 SHCN 患儿相似,可能受益于针对严重慢性疾病的合作计划。然而,与没有这些问题的儿童相比,患有 CP 及相关疾病的儿童存在未满足医疗保健需求的几率更高。