Family-Provided Health Care for Children With Special Health Care Needs
Family-Provided Health Care for Children With Special Health Care Needs
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DOI：
10.1542/peds.2016-1287
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发表时间：
2017-01-01
期刊：
影响因子：
8
通讯作者：
Schuster, Mark A.
中科院分区：
文献类型：
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作者：
Romley, John A.;Shah, Aakash K.;Schuster, Mark A.
背景和目的：许多有特殊卫生保健需要的儿童（CSHCN）在家中接受家庭成员的卫生保健，但这种保健的程度很难量化。本研究的目标是创建一个配置文件的CSHCN谁接受家庭提供的医疗保健，并量化这种care.METHODS的程度：我们分析了数据从2009-2010年全国调查的儿童有特殊医疗保健需求，全国代表性的样本40 242父母/监护人的CSHCN。结果包括CSHCN及其家庭的社会人口学特征，家庭成员在家中为CSHCN提供医疗保健所花费的时间，以及此类护理的总经济成本。护理时间进行了评估（1）雇用替代照顾者的成本（“重置成本”的方法），和（2）照顾者的工资（“放弃收入”的方法）。结果：大约560万美国CSHCN收到15亿小时，每年的家庭提供的医疗保健。以2015年的美元计算，更换家庭健康助理估计每年将花费357亿美元或6400美元（按最低工资计算，每年每个孩子116亿美元或2100美元）。相关的放弃收入为176亿美元，即每个孩子每年3200美元。CSHCN最有可能收到最大的家庭提供的医疗保健在家里的年龄为0至5岁，是西班牙裔，生活在联邦贫困线以下，没有父母/监护人谁已经完成高中，有公共和私人保险，并有严重的条件/problems.Conclusions：美国家庭提供了大量的医疗保健在家里CSHCN，代表了大量的经济成本。
BACKGROUND AND OBJECTIVES: Many children with special health care needs (CSHCN) receive health care at home from family members, but the extent of this care is poorly quantified. This study's goals were to create a profile of CSHCN who receive family-provided health care and to quantify the extent of such care.METHODS: We analyzed data from the 2009-2010 National Survey of Children with Special Health Care Needs, a nationally representative sample of 40 242 parents/guardians of CSHCN. Outcomes included sociodemographic characteristics of CSHCN and their households, time spent by family members providing health care at home to CSHCN, and the total economic cost of such care. Caregiving hours were assessed at (1) the cost of hiring an alternative caregiver (the "replacement cost" approach), and (2) caregiver wages (the "foregone earnings" approach).RESULTS: Approximately 5.6 million US CSHCN received 1.5 billion hours annually of family-provided health care. Replacement with a home health aide would have cost an estimated $35.7 billion or $6400 per child per year in 2015 dollars ($11.6 billion or $2100 per child per year at minimum wage). The associated foregone earnings were $17.6 billion or $3200 per child per year. CSHCN most likely to receive the greatest amount of family-provided health care at home were ages 0 to 5 years, were Hispanic, lived below the federal poverty level, had no parents/guardians who had finished high school, had both public and private insurance, and had severe conditions/problems.CONCLUSIONS: US families provide a significant quantity of health care at home to CSHCN, representing a substantial economic cost.