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Developing a measure of unmet health care needs for a pediatric population
P Liberatos1, J Elinson, T Schaffzin
1Medical and Health Research Association of NYC, Inc., New York 10013, USA.
Insights
A new measure accurately assesses unmet pediatric health care needs. This simple, inexpensive tool helps evaluate interventions and monitor health equity in children and adolescents.
Area of Science:
- Pediatric Health Services Research
- Health Care Access and Equity
- Health Outcomes Measurement
Background:
- Quantified measures of unmet health care needs are crucial for evaluating interventions, managed care impacts, population health trends, and health equity.
- Existing measures need to be simple, cost-effective, and population-specific for effective application.
- Assessing unmet needs in pediatric populations requires tailored measurement tools.
Purpose of the Study:
- To develop and validate a specific measure of unmet health care needs for pediatric populations.
- To adapt existing measurement methodologies for use in children and adolescents.
- To provide a tool for assessing primary care access and utilization in young individuals.
Main Methods:
- The study involved 1,031 children (aged 1-5) and 172 adolescent mothers (aged 13-19) from low-income, minority backgrounds in New York City.
- A symptoms-response ratio measure, adapted from prior work, was employed, assessing experienced symptoms and healthcare seeking behavior.
- A panel of pediatricians evaluated the necessity of seeking healthcare for the reported symptoms.
Main Results:
- The developed measure demonstrated adequate inter-rater reliability and good construct validity.
- Children's health service utilization aligned with pediatricians' expectations, though unmet needs varied by symptom.
- Adolescents accessed care less frequently than recommended by the expert panel.
Conclusions:
- The symptoms-response ratio offers a practical, economical method for estimating unmet primary care needs.
- This pediatric-specific measure effectively targets the healthcare needs of young children and adolescent females.
- The findings highlight potential disparities in healthcare access for adolescents within the studied population.
Background:
Quantified measures of unmet health care needs can be used to evaluate health care interventions, assess the impact of managed care, monitor health status trends in populations, or assess equity of access to medical care across population subgroups. Such a measure needs to be simple, relatively easy to obtain, inexpensive, and appropriately targeted to the population of interest.
Objective:
To develop a measure of unmet health care needs that is specifically targeted to a pediatric population.
Subjects:
Study participants consisted of children, aged 1 to 5 years (n = 1,031), and adolescent mothers, aged 13 to 19 years (n = 172), predominantly from poor, minority families in New York City.
Research Design:
Based on a measure, the symptoms-response ratio, developed for all age groups, this study replicated Taylor's procedures specifically for children and adolescents. Respondents were asked if they had experienced a set of physical symptoms and if they saw a doctor in response. A panel of pediatricians rated the same symptoms as to whether health care should be sought.
Results:
The measure achieved adequate inter-rater reliability and good construct validity. The children's overall use of health services did not differ from the pediatric panel's expectations, but with differing degrees of unmet needs by symptom. Adolescents sought care less often than the expert panel members believed they should.
Conclusions:
The symptoms-response ratio provides a good balance of a simple and inexpensive measure while yielding a fair estimate of unmet needs for primary care. This analysis created a pediatric measure targeted to the needs of young children and adolescent females.