Kristin Hittle Gigli, Assistant Professor, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX..
Genevieve Graaf, Assistant Professor, School of Social Work, University of Texas at Arlington, Arlington, TX.
J Pediatr Health Care. 2023 Mar-Apr;37(2):185-192. doi: 10.1016/j.pedhc.2022.09.008. Epub 2022 Sep 21.
Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020.
Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analysis.
The final sample included 17,065 CYSHCN. In the fully adjusted analysis, there was a significant decrease in odds of accessing preventive dental care (adjusted odds ratio [AOR], 0.63; 95%confidence interval [CI], 0.51-0.77) and increased odds of unmet mental health care needs (AOR,1.34; 95% CI, 1.02-1.77). The inability to obtain an appointment was a barrier that increased during the study period (AOR, 2.77; 95% CI, 1.71-4.46).
Novel pandemic related policies may have mitigated negative impacts on health care access for CYSHCN.
有特殊医疗需求的儿童和青少年（CYSHCN）容易受到医疗服务中断的影响，因此出台了相关政策来减轻与 COVID-19 相关的服务中断。本研究旨在对比 2019 年和 2020 年 CYSHCN 的医疗服务使用情况和医疗服务可及性。
利用全国儿童健康调查数据，识别出有特殊医疗需求的儿童和青少年，并使用多变量逻辑回归分析评估医疗服务使用情况、未满足的医疗需求、获取医疗服务的障碍以及医疗服务可及性方面的差异。
最终纳入 17065 名有特殊医疗需求的儿童和青少年。在完全调整后的分析中，预防牙科保健服务的可及性显著降低（调整后的优势比[OR]，0.63；95%置信区间[CI]，0.51-0.77），而未满足的心理健康服务需求的可能性增加（OR，1.34；95%CI，1.02-1.77）。在研究期间，无法获得预约成为一个障碍，其出现的可能性增加（OR，2.77；95%CI，1.71-4.46）。
与新冠疫情相关的新政策可能减轻了对 CYSHCN 医疗服务可及性的负面影响。
