Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs
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Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs Myra Rosen-Reynoso2 • Michelle V. Porche1 • Ngai Kwan2 • Christina Bethell3 Veronica Thomas2 • Julie Robertson4 • Eva Hawes4 • Susan Foley2 • Judith Palfrey5
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Published online: 4 January 2016 Springer Science+Business Media New York 2015
Abstract Objectives Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009–2010) and using the revised criteria for ‘‘ease of use,’’ we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. Methods We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the ‘‘ease of use’’ criteria with socio-demographic,
complexity of need, and access variables. Results Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. Conclusions for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources. Keywords Special-needs children Disparities Survey Medical home
& Myra Rosen-Reynoso [email protected]
Susan Foley [email protected] Judith Palfrey [email protected]
Michelle V. Porche [email protected] Ngai Kwan [email protected] Christina Bethell [email protected] Veronica Thomas [email protected] Julie Robertson [email protected] Eva Hawes [email protected]
1
School of Education, Boston University, Two Silber Way, Boston, MA 02215, USA
2
Institute for Community Inclusion, University of Massachusetts, Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
3
Johns Hopkins University, Baltimore, MD, USA
4
Oregon Health and Science University, Portland, OR, USA
5
Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA
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Significance Statement What is already known on this subject? Differences in ease of use of community-based s
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