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有听力障碍的儿童健康全面发展(CSHCN):在获得医疗护理和护理质量方面的差距。

CSHCN with hearing difficulties: Disparities in access and quality of care.

机构信息

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, MD, USA.

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, MD, USA.

出版信息

Disabil Health J. 2020 Jan;13(1):100798. doi: 10.1016/j.dhjo.2019.04.002. Epub 2019 Apr 27.

Abstract

BACKGROUND

Hearing difficulties (HD) affect a sizable minority of children in the United States and can have a significant impact on child development. Children with HD may face barriers around language development, communication abilities, learning, and social interactions, which in turn can affect multiple aspects of their lives.

OBJECTIVE/HYPOTHESIS: Little is known about the extent to which children with HD have access to a system of care and we hypothesize that this population may experience significant unmet needs.

METHODS

In this cross-sectional study, using bivariate and multivariable regression models, we analyzed data from the 2009/2010 National Survey of Children with Special Health Care Needs (NS-CSHCN). Selected survey items were used to assess health and healthcare characteristics of CSHCN with some level of HD (n = 2,315) compared to those without HD (n = 37,851). The study sample included 40,242 CSHCN aged 0-17 years, whose caregivers responded to the survey.

RESULTS

Approximately 694,000 CSHCN in the U.S. were reported to have any level of HD, representing 6.3% of the CSHCN population. Compared to CSHCN without HD, those with HD were less likely to have access to a medical home, community services, or have adequate health insurance.

CONCLUSIONS

Significant deficits in medical home access, adequate insurance, and accessibility of community-based services are evident for CSHCN with HD. Families having knowledge of how and when to access community services and partner with providers in their child's health care is important for the overall health and wellbeing of this subpopulation of CSHCN.

摘要

背景

听力障碍(HD)影响了美国相当一部分儿童,对儿童的发展有重大影响。有听力障碍的儿童在语言发展、沟通能力、学习和社会交往方面可能面临障碍,这反过来又会影响他们生活的多个方面。

目的/假设:对于有听力障碍的儿童获得护理系统的程度知之甚少,我们假设这一人群可能存在大量未满足的需求。

方法

在这项横断面研究中,我们使用双变量和多变量回归模型,分析了 2009/2010 年全国特殊健康需要儿童调查(NS-CSHCN)的数据。使用选定的调查项目来评估一定程度的听力障碍(n=2315)和无听力障碍(n=37851)的 CSHCN 的健康和医疗保健特征。研究样本包括 40242 名年龄在 0-17 岁的 CSHCN,其照顾者对调查做出了回应。

结果

据报告,美国约有 694000 名 CSHCN存在某种程度的听力障碍,占 CSHCN 人口的 6.3%。与无听力障碍的 CSHCN 相比,有听力障碍的儿童更不可能获得医疗之家、社区服务或拥有足够的健康保险。

结论

有听力障碍的 CSHCN 在获得医疗之家、充足的保险和社区服务的可及性方面存在明显的不足。了解如何以及何时获得社区服务并与儿童医疗保健提供者合作的家庭对这一小部分 CSHCN 的整体健康和福祉很重要。

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