Research Department, Children's Specialized Hospital, New Brunswick, NJ.
Physiatry Section, Children's Specialized Hospital, Mountainside, NJ.
J Dev Behav Pediatr. 2021;42(8):605-612. doi: 10.1097/DBP.0000000000000950.
To examine the physical and functional health of children with cerebral palsy (CP) and determine the prevalence and correlates of unmet need for health care coordination among this population.
We analyzed data from the 2016 to 2018 National Survey of Children's Health (n = 102,341). Bivariate and multivariable analyses were conducted to compare the prevalence of chronic health conditions, functional disabilities, and care coordination among children with and without CP. Multivariable logistic regression models were used to estimate the adjusted odds ratio of comorbid conditions, functional disabilities, and unmet need for care coordination. Associations between select sociodemographic factors and unmet need for care coordination were assessed.
Children with CP had significantly higher prevalence of all the comorbid conditions and functional disabilities examined. The most prevalent health conditions among children with CP were allergies (34.2%), anxiety (26.5%), and asthma (25.1%). Notably, children with CP had higher odds of autism spectrum disorder (adjusted odds ratio [aOR] = 2.97; 95% confidence interval [CI] 1.40-6.30) and mental health conditions (aOR = 3.65; 95% CI 2.15-6.21). More than half (53.8%) of children with CP had unmet need for care coordination. They also had higher odds of unmet need for care coordination than children without CP (aOR = 2.63; 95% CI 1.69-4.10).
Children with CP have high prevalence of chronic health conditions and are also more likely to have unmet need for care coordination. Given the complexity of CP, our study supports the need for robust efforts to ensure that all children with CP have effective care coordination.
检查脑瘫(CP)儿童的身体和功能健康状况,并确定该人群中医疗保健协调需求未得到满足的发生率和相关因素。
我们分析了 2016 年至 2018 年全国儿童健康调查(n=102341)的数据。采用双变量和多变量分析比较了脑瘫儿童和非脑瘫儿童慢性健康状况、功能障碍和医疗保健协调需求未得到满足的发生率。采用多变量逻辑回归模型估计合并症、功能障碍和医疗保健协调需求未得到满足的调整比值比。评估了选择社会人口统计学因素与医疗保健协调需求未得到满足之间的关联。
脑瘫儿童所有检查的合并症和功能障碍的发生率均显著更高。脑瘫儿童最常见的健康状况包括过敏(34.2%)、焦虑(26.5%)和哮喘(25.1%)。值得注意的是,脑瘫儿童患自闭症谱系障碍的几率更高(调整后的比值比[aOR]为 2.97;95%置信区间[CI]为 1.40-6.30)和心理健康状况(aOR=3.65;95%CI 2.15-6.21)。超过一半(53.8%)的脑瘫儿童医疗保健协调需求未得到满足。与非脑瘫儿童相比,他们更有可能需要医疗保健协调(aOR=2.63;95%CI 1.69-4.10)。
脑瘫儿童慢性健康状况发生率高,且更有可能需要医疗保健协调。鉴于 CP 的复杂性,我们的研究支持需要做出有力的努力,以确保所有 CP 儿童都能得到有效的医疗保健协调。