Preventive health care for children with and without special health care needs
Preventive health care for children with and without special health care needs
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DOI：
10.1542/peds.2006-1896
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发表时间：
2007-04-01
期刊：
影响因子：
8
通讯作者：
Newacheck, Paul W.
中科院分区：
文献类型：
--
作者：
Houtrow, Amy J.;Kim, Sue E.;Newacheck, Paul W.
目标。本研究的目的是比较有和没有特殊卫生保健需要的儿童接受预防性卫生保健服务的情况，并利用具有全国代表性的数据确定有特殊卫生保健需要的儿童接受这些卫生保健服务的预测因素。分析了2002年和2003年医疗开支小组调查的数据。本研究共纳入18 279名3 ~ 17岁儿童。使用儿童预防性健康补充来确定照顾者对过去12个月内具体健康检查措施和预期指导的回忆。计算特殊卫生保健需要儿童预防服务的预测因素的优势比。3至17岁儿童中有特殊保健需求的患病率为21.6%。根据看护人的报告，87.5%有特殊保健需要的儿童在过去一年中接受了>= 1健康检查，而没有特殊保健需要的儿童的这一比例为73.1%。据报告，69.8%有特殊保健需要的儿童接受了>= 1主题的预期指导，而没有特殊保健需要的儿童则为55.2%。有特殊卫生保健需要的儿童的黑人和西班牙裔照顾者比其他人更有可能报告接受了本研究中测量的所有6类预期指导。我们发现，有特殊保健需要儿童的照顾者比没有特殊保健需要儿童的照顾者更有可能报告接受预期指导和健康筛查。虽然这些护理人员中的大多数报告每年都接受一些健康检查和预期指导，但在提供预防性保健服务方面存在明显差距。这项研究确定了在向有特殊保健需要的儿童和一般儿童提供预防性保健服务方面有待改进的领域。
OBJECTIVE. The objective of this study was to compare the receipt of preventive health services for children with and without special health care needs and to identify predictors of these health services for children with special health care needs using nationally representative data.METHODS. Data from the 2002 and 2003 Medical Expenditure Panel Surveys were analyzed. A total of 18 279 children aged 3 to 17 years were included in our study. The Child Preventive Health Supplement was used to identify caregiver recall of specific health screening measures and anticipatory guidance during the previous 12 months. Odds ratios were calculated for predictive factors of preventive services for children with special health care needs.RESULTS. The prevalence of special health care needs in children aged 3 to 17 years was 21.6%. Based on caregiver reports, 87.5% of children with special health care needs had >= 1 health screening measure checked in the past year compared with 73.1% of children without special health care needs. Receipt of >= 1 topic of anticipatory guidance was reported for 69.8% of children with special health care needs compared with 55.2% of children without special health care needs. Black and Hispanic caregivers of children with special health care needs were more likely than others to report receipt of all 6 categories of anticipatory guidance measured in this study.CONCLUSIONS. We found that caregivers of children with special health care needs were more likely to report receipt of anticipatory guidance and health screening than were caregivers of children without special health care needs. Although a majority of these caregivers reported receiving some health screening and anticipatory guidance on an annual basis, there are clear gaps in the delivery of preventive health services. This study identifies areas for improvement in the delivery of preventive health services for children with special health care needs and children in general.