Children With Special Needs: Social Determinants of Health and Care Coordination

Clin Pediatr (Phila). 2020 Nov;59(13):1161-1168. doi: 10.1177/0009922820941206. Epub 2020 Jul 16.

Abstract

Care coordination (CC) facilitates access to resources/services for children/youth with special health care needs (CYSHCN). We conducted a cross-sectional analysis of the 2009-2010 National Survey of CSHCN to examine socioeconomic factors related to report of receiving adequate CC services for CYSHCN. Descriptive statistics were used to describe sociodemographic characteristics of respondents and examine socioeconomic factors. Receiving adequate CC varied by socioeconomic variables including income (100% to 199% federal poverty line [FPL]; aOR [adjusted odds ratio] = 0.848; 95% CI [confidence interval] = 0.722-0.997; P < .05), insurance (uninsured; aOR = 0.446; 95% CI = 0.326-0.609; P < .0001), and marital status (never married; aOR = 0.79; 95% CI = 0.64-0.97; P < .05). More families reporting adequate CC had private insurance, non-Hispanic white ethnicity, income >400% federal poverty level, and 2-parent households. Findings suggest unmet needs in terms of adequate access or knowledge leading to insufficient provision of CC for families with the greatest needs. Further analysis identifying specific deficits and implementing strategies to address these disparities is warranted.

Keywords: access; care coordination; children; social determinants of health; socioeconomic; special health care needs.

MeSH terms

  • Adolescent
  • Child
  • Child Health Services
  • Cross-Sectional Studies
  • Disabled Children / statistics & numerical data*
  • Female
  • Health Care Surveys / methods
  • Health Care Surveys / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Medically Uninsured / statistics & numerical data
  • Needs Assessment / statistics & numerical data
  • Poverty / statistics & numerical data
  • Social Determinants of Health / statistics & numerical data*
  • Socioeconomic Factors
  • United States