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Respite care for children with special health care needs
1Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. snageswa@wfubmc.edu
Insights
Many children with special health care needs (CSHCN) require respite care, but a significant portion of these needs go unmet. Factors like functional limitations and maternal education influence access to essential respite services for CSHCN.
Area of Science:
- Pediatric Health
- Health Services Research
- Family Support
Background:
- Children with special health care needs (CSHCN) often require extensive family support.
- Respite care services are crucial for alleviating caregiver burden and supporting families of CSHCN.
- Understanding the prevalence and determinants of unmet respite care needs is vital for improving healthcare access.
Purpose of the Study:
- To identify the characteristics of CSHCN needing respite care.
- To determine factors associated with unmet respite care needs among CSHCN.
- To inform strategies for enhancing respite care accessibility for these families.
Main Methods:
- Cross-sectional study utilizing data from the 2001 National Survey of Children With Special Health Care Needs.
- Analysis of sociodemographic factors and health status in relation to respite care needs and service utilization.
- Multivariate analysis to identify predictors of unmet respite care needs.
Main Results:
- 8.8% of CSHCN reported a need for respite care; 24% of those with needs did not receive services.
- Younger age, insurance gaps, public insurance, functional limitations, and unstable health increased the likelihood of needing respite care.
- Higher maternal education, functional limitations, and unstable health were associated with greater unmet respite care needs.
Conclusions:
- A substantial proportion of respite care needs for CSHCN remain unmet.
- Targeted interventions are necessary to improve access to respite care for families of CSHCN.
- Policy and practice adjustments are needed to address disparities in respite care access.
Objectives:
To describe (1) the subpopulation of children with special health care needs (CSHCN) in need of respite care and (2) the factors associated with unmet respite care needs.
Design:
Cross-sectional study using the 2001 National Survey of Children With Special Health Care Needs.
Setting:
The United States.
Participants:
Caregivers of CSHCN.
Main Outcome Measures:
We determined the association of sociodemographic factors and health status of CSHCN with need for respite care and unmet needs for respite care.
Results:
Of the 38 831 respondents, 3178 (8.8%) reported need for respite care in the prior 12 months. The CSHCN who were young and uninsured/had insurance gaps or had public insurance and those with functional limitations and unstable health conditions were more likely to need respite care. Twenty-four percent of CSHCN who needed respite care did not receive such services. In multivariate analysis, higher maternal education (adjusted odds ratio [AOR], 1.6 for more than high school education compared with high school education or less), some and severe functional limitations (AORs, 2.5 and 5.6, respectively, compared with no limitation), and unstable health condition (AOR, 2.3 compared with stable condition) were associated with greater unmet respite care needs. The CSHCN with public insurance were half as likely and CSHCN with private insurance were as likely to report unmet respite care needs as those who were uninsured/with insurance gaps.
Conclusions:
Respite care needs of CSHCN are frequently unmet. Furthermore, strategies are needed to improve access to respite care for families of CSHCN.
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