Children With Special Health Care Needs: How Special Are Their Health Care Needs?
Children With Special Health Care Needs: How Special Are Their Health Care Needs?
复制标题
DOI：
10.1016/j.acap.2020.01.007
复制
发表时间：
2020-11-01
影响因子：
3.1
通讯作者：
Dalziel, Kim
中科院分区：
文献类型：
--
作者：
Huang, Li;Freed, Gary L.;Dalziel, Kim
目的：评估全科医生、专科医生、急诊科、医院住院和医院门诊为有特殊卫生保健需要的儿童提供的服务的使用和需求。评估水平的CSHCN的需求相比，与其他children.METHODS：卫生服务的使用和需求为4至15岁的儿童进行了评估，使用具有全国代表性的纵向研究澳大利亚儿童调查25,011观察。估计了CSHCN与其他儿童相比的服务使用和未满足需求的比值比。CSHCN进一步分组为1）只需要额外的药物治疗，2）只需要额外的医疗护理，或3）需要两者定义的CSHCN筛选questions.RESULTS：符合CSHCN标准的患病率为16.1%。在过去的12个月里，77.7%的CSHCN使用任何全科医生护理，46.4%，21.7%，12.4%和15.0%，分别使用专科护理，急诊科，住院和门诊服务。大约一半的CSHCN被确定为由于需要额外的药物而具有特殊需求。他们的服务使用和未满足的需求只是略有增加。另一组需要更多药物和医疗护理的CSHCN占所有CSHCN的不到三分之一。这些儿童有最高的赔率使用专科护理（比值比12.3，P <0.001），并有未满足的专科护理需求（比值比7.4，P <0.001）相比，儿童没有特殊需求。结论：我们的研究结果强调了确保专科护理的重要性CSHCN，特别是三分之一的需求最高。这一估计可以指导未来的护理计划。
OBJECTIVE: To assess use and needs for general practitioner, specialist, emergency department, hospital inpatient, and hospital outpatient services for children with special health care needs (CSHCN). To assess the level of CSHCN's needs compared with other children.METHODS: Health service use and needs for children aged 4 to 15 years were assessed using the nationally representative Longitudinal Study of Australian Children survey with 25,011 observations. Odds ratios of service use and unmet needs for CSHCN compared to other children were estimated. CSHCN were further grouped as those 1) needing only additional medication, 2) needing only additional medical care, or 3) needing both as defined by the CSHCN screener questions.RESULTS: The prevalence of those meeting criteria for CSHCN was 16.1%. In the past 12 months, 77.7% of CSHCN used any general practitioner care and 46.4%, 21.7%, 12.4%, and 15.0%, respectively, used specialty care, emergency department, hospital inpatient, and outpatient services. Approximately half of CSHCN were identified as having special needs due to needing additional medication. Their service use and unmet needs are only slightly elevated. Another group of CSHCN who need both more medication and medical care comprises less than one third of all CSHCN. These children have the highest odds of using specialty care (odds ratio 12.3, P < .001), and of having unmet specialty care need (odds ratio 7.4, P < .001) compared to children without special needs.CONCLUSIONS: Our findings highlight the importance of ensuring specialty care for CSHCN, especially the one third with most elevated needs. This estimate might guide future care planning.