根据家庭语言使用情况，美国有特殊医疗需求儿童的医疗质量指标差异

Disparities in Health Care Quality Indicators among US Children with Special Health Care Needs According to Household Language Use.

作者信息

Yu Stella, Lin Sue, Strickland Bonnie

机构信息

The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., Riverdale, MD 20738, USA.

US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Rockville, MD 20857, USA.

出版信息

Int J MCH AIDS. 2015;4(1):3-12. doi: 10.21106/ijma.51.

DOI:10.21106/ijma.51

PMID:27621998

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4948155/

Abstract

BACKGROUND

Lower health care utilization and less favorable health outcomes have been demonstrated in children from Non-English Primary Language households (NEPL) in previous studies. This study examines prevalence of health care quality indicators among US children with special health care needs (CSHCN) and their association with household language use.

METHODS

We used data from the 2009-2010 National Survey of Children with Special Health Care Needs, restricted to an analytic sample of 40,242 children. Logistic regression models were used to examine the effects of primary household language on the attainment of the 6 health care quality indicators for CSHCN.

RESULTS

Compared to CSHCN from English primary language households (EPL), CSHCN from NEPL households had 31% higher odds of not feeling like partners in health care decision-making. They had 67% higher odds of lacking care through a medical home and 42% higher odds of reporting inadequate health insurance. NEPL children had 32% higher odds of not receiving early and continuous screening for special health care needs. NEPL youths had 69% higher odds of not receiving services for transition to adulthood. Minority race/ethnicity, lower income and families other than two biological parents all conferred additional risks to not attaining quality indicators. Publicly insured or uninsured CSHCN were also at higher risk.

CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS

Our study provides compelling evidence that significant disparities exist for CSHCN by primary household language status across all health care quality indicators. Establishment of effective surveillance systems and targeting of outreach programs in both developed and developing countries may lead to improved understanding of health care needs and quality of services and reduction of health disparities for this underserved population.

摘要

背景

先前的研究表明，来自非英语母语家庭（NEPL）的儿童医疗保健利用率较低，健康状况也较差。本研究调查了美国有特殊医疗保健需求的儿童（CSHCN）中医疗保健质量指标的患病率及其与家庭语言使用的关系。

方法

我们使用了2009 - 2010年全国有特殊医疗保健需求儿童调查的数据，限于40242名儿童的分析样本。使用逻辑回归模型来检验家庭主要语言对CSHCN六项医疗保健质量指标达成情况的影响。

结果

与来自英语母语家庭（EPL）的CSHCN相比，来自NEPL家庭的CSHCN在医疗保健决策中感觉自己不是参与者的几率高31%。他们通过医疗之家获得护理的几率低67%，报告医疗保险不足的几率高42%。NEPL儿童未接受特殊医疗保健需求早期和持续筛查的几率高32%。NEPL青少年未接受向成年过渡服务的几率高69%。少数族裔、低收入以及非双亲家庭在未达成质量指标方面都带来了额外风险。由公共保险或未参保的CSHCN风险也更高。