Children With Special Health Care Needs on Supplemental Security Income for Disability Have More Health Impacts and Needs Than Other Children With Special Health Care Needs on Medicaid
Children With Special Health Care Needs on Supplemental Security Income for Disability Have More Health Impacts and Needs Than Other Children With Special Health Care Needs on Medicaid
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DOI：
10.1016/j.acap.2019.10.014
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发表时间：
2020-03-01
影响因子：
3.1
通讯作者：
Stein, Ruth E. K.
中科院分区：
文献类型：
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作者：
Houtrow, Amy J.;Carle, Adam;Stein, Ruth E. K.
目的：针对残疾儿童的补充安全收入（SSI）计划最近受到了公众和政治的审查。我们试图通过比较医疗服务利用率、高质量医疗服务指标和家庭影响，来确定接受残疾SSI的医疗补助/SCH1P中有特殊医疗需求的儿童（CSHCN）是否比接受医疗补助/SCH1P的其他CSHCN更严重地受到健康状况的影响。方法：使用2009/2010年全国CSHCN调查，我们将参加Medicaid/SCHIP的CSHCN人群分为两组：参加SS1残疾计划的CSHCN和其他CSHCN。我们比较了这两组的健康状况严重程度、卫生服务需求和未满足需求、卫生系统质量指标和家庭影响。结果：SSI患者受健康状况影响的调整几率（aOR）为4.33(3.33-5.9)，有2项及以上功能困难的调整几率（aOR）为3.38（2.83-4.03）。SSI的CSHCN有更高的医疗保健需求，但没有更高的未满足需求。受SSI影响的CSHCN家庭工作损失较多，aOR = 3.01(2.52 ~ 3.59)，经济问题较多，aOR = 1.68（1.38 ~ 2.04）。结论：本研究表明，与其他低收入儿童相比，接受SSI的CSHCN儿童的严重程度和广泛的卫生服务需求更高。接受特殊福利援助的未成年儿童在健康状况方面遇到的困难要大得多，他们的健康状况对父母的日常生活的影响也要大得多。
OBJECTIVE: The Supplemental Security Income (SSI) program for children with disabilities has come under recent public and political scrutiny. We sought to determine if children with special health care needs (CSHCN) on Medicaid/SCH1P who receive SSI for disability were more severely impacted by their health conditions compared to other CSHCN on Medicaid/SCHIP by comparing their health service utilization, markers of quality health care, and family impacts.METHODS: Using the 2009/2010 National Survey of CSHCN, we divided the population of CSHCN on Medicaid/SCHIP into 2 groups: CSHCN on SS1 for disability and other CSHCN. We compared these 2 groups on measures of health condition severity, health service need and unmet need, health system quality measures, and family impact.RESULTS: CSHCN on SSI had significantly higher adjusted odds of being affected by their health conditions, aOR = 4.33 (3.33-5.9) and having 2 or more functional difficulties, AOR = 3.38 (2.83-4.03). CSHCN on SSI had significantly higher health care needs but not higher unmet needs. The families of CSHCN on SSI experienced more work loss, aOR = 3.01 (2.52-3.59) and more financial problems, aOR = 1.68 (1.38-2.04).CONCLUSION: This study indicates higher severity and extensive health service needs among CSHCN receiving SSI, compared to other low income children. CSHCN receiving SSI experience substantially more difficulty related to their health conditions and their conditions have considerably more impact on the daily lives of their parents.