Caring for Children with Special Health Care Needs: Profiling Pediatricians and Their Health Care Resources
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Caring for Children with Special Health Care Needs: Profiling Pediatricians and Their Health Care Resources Megumi J. Okumura1,2,3 · Heather A. Knauer1,4 · Kris E. Calvin5 · John I. Takayama1
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers. We performed a logistic regression model on having an “above average proportion” of CSHCN in practice, adjusting for demographics, practice type (rural vs. suburban/urban) and medical resources, care satisfaction, and ease of subspecialty access. Results Our response rate was 50.2% (n = 1290); 75% of respondents reported providing some primary care services, with many primary care pediatricians caring for a high proportion of CSHCN. Pediatricians reported an average of 28% CSHCN in their practices. Rural pediatricians lacked subspecialty access (10–59% reporting no access to the various subspecialties). Factors relating to higher CSHCN in practice included being in academic medical centers and satisfaction in caring for CSHCN. Conclusions Pediatricians report lack of access to mental health services, care coordination and case management. Academic medical centers and higher physician satisfaction in care delivery for CSHCN are associated with more CSHCN in practice. Promoting ways to support pediatricians, such as practice collaboration with behavioral specialists, may be necessary to encourage primary care pediatricians to provide medical homes for CSHCN. Keywords Children with special health care needs · Medical Home · Pediatrician · Practice resources Abbreviations AAP American Academy of Pediatrics CA California CSHCN Children with special health care needs CCS California Children’s Services
Significance Few studies have surveyed physicians about providing care for children with special health care needs (CSHCN). This study describes the pediatrician perspective of the clinical landscape for caring for CSHCN in California, the types of Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-018-2484-3) contains supplementary material, which is available to authorized users. * Megumi J. Okumura [email protected] Extended author information available on the last page of the article
conditions they are treating, and access to subspecialty and practice resources; and determines pediatrician and practice characteristics associated with increased proportion of CSHCN in their practices.
Background Children with sp
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