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患有发育障碍儿童的健康需求和服务利用情况 - 美国,2014-2018 年。

Health Needs and Use of Services Among Children with Developmental Disabilities - United States, 2014-2018.

出版信息

MMWR Morb Mortal Wkly Rep. 2022 Mar 25;71(12):453-458. doi: 10.15585/mmwr.mm7112a3.


DOI:10.15585/mmwr.mm7112a3
PMID:35324879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8956340/
Abstract

Developmental delays, disorders, or disabilities (DDs) manifest in infancy and childhood and can limit a person's function throughout life* (1-3). To guide strategies to optimize health for U.S. children with DDs, CDC analyzed data from 44,299 participants in the 2014-2018 National Health Interview Survey (NHIS). Parents reported on 10 DDs, functional abilities, health needs, and use of services. Among the approximately one in six (17.3%) U.S. children and adolescents aged 3-17 years (hereafter children) with one or more DDs, 5.7% had limited ability to move or play, 4.7% needed help with personal care, 4.6% needed special equipment, and 2.4% received home health care, compared with ≤1% for each of these measures among children without DDs. Children with DDs were two to seven times as likely as those without DDs to have taken prescription medication for ≥3 months (41.6% versus 8.4%), seen a mental health professional (30.6% versus 4.5%), a medical specialist (26.0% versus 12.4%), or a special therapist, such as a physical, occupational, or speech therapist, (25.0% versus 4.5%) during the past year, and 18 times as likely to have received special education or early intervention services (EIS) (41.9% versus 2.4%). These percentages varied by type of disability and by sociodemographic subgroup. DDs are common, and children with DDs often need substantial health care and services. Policies and programs that promote early identification of children with developmental delays and facilitate increased access to intervention services can improve health and reduce the need for services later in life. Sociodemographic inequities merit further investigation to guide public health action and ensure early and equitable access to needed care and services.

摘要

发育迟缓、障碍或残疾(DDs)在婴儿期和儿童期表现出来,并可能限制一个人一生的功能*(1-3)。为了指导为美国有 DDs 的儿童优化健康的策略,CDC 分析了 2014-2018 年全国健康访谈调查(NHIS)中 44299 名参与者的数据。父母报告了 10 种 DDs、功能能力、健康需求和服务使用情况。在大约六分之一(17.3%)的美国 3-17 岁(以下简称儿童)有一个或多个 DDs 的儿童中,有 5.7%的儿童移动或玩耍能力有限,4.7%的儿童需要个人护理帮助,4.6%的儿童需要特殊设备,2.4%的儿童接受家庭保健,而无 DDs 的儿童中这些指标的比例均≤1%。有 DDs 的儿童服用处方药≥3 个月的可能性是没有 DDs 的儿童的两到七倍(41.6%比 8.4%),看心理健康专业人员的可能性是没有 DDs 的儿童的 30.6%比 4.5%,看医疗专家的可能性是没有 DDs 的儿童的 26.0%比 12.4%,看特殊治疗师(如物理治疗师、职业治疗师或言语治疗师)的可能性是没有 DDs 的儿童的 25.0%比 4.5%,在过去一年中接受特殊教育或早期干预服务(EIS)的可能性是没有 DDs 的儿童的 18 倍(41.9%比 2.4%)。这些百分比因残疾类型和社会人口统计学亚组而异。DDs 很常见,有 DDs 的儿童通常需要大量的医疗保健和服务。促进早期发现发育迟缓儿童并促进增加获得干预服务的机会的政策和计划可以改善健康状况,并减少日后对服务的需求。社会人口不公平现象值得进一步研究,以指导公共卫生行动,并确保早期和公平地获得所需的护理和服务。

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本文引用的文献

[1]
Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening.

Pediatrics. 2019-12-16

[2]
Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017.

Pediatrics. 2019-10

[3]
Geographic Disparities in Treatment for Children with Autism Spectrum Disorder.

Acad Pediatr. 2019-3-8

[4]
Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010-2016: Implications for Future Health Reforms.

J Adolesc Health. 2018-3-26

[5]
Factors related to early intervention Part C enrollment: A systematic review.

Disabil Health J. 2017-1-28

[6]
Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

Matern Child Health J. 2016-5

[7]
Taking stock of the CSHCN screener: a review of common questions and current reflections.

Acad Pediatr. 2014-12-5

[8]
Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities, National Health Interview Survey, 2006-2010.

Res Dev Disabil. 2011-11-24

[9]
Health care use and health and functional impact of developmental disabilities among US children, 1997-2005.

Arch Pediatr Adolesc Med. 2009-1

[10]
A new definition of children with special health care needs.

Pediatrics. 1998-7

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