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Inequities in health care needs for children with medical complexity

Dennis Z Kuo1, Anthony Goudie2, Eyal Cohen3

  • 1Dennis Z. Kuo (dzkuo@uams.edu) is an associate professor of pediatrics at the University of Arkansas for Medical Sciences, in Little Rock.

Health Affairs (Project Hope)
|December 10, 2014
PubMed

Insights

Children with medical complexity face significant health care access inequities. Medical complexity itself, rather than socioeconomic factors, is a primary driver of unmet health needs for these children.

Area of Science:

  • Pediatric Health Services Research
  • Health Equity Studies
  • Child Health Outcomes

Background:

  • Children with special health care needs (CSHCN) are vulnerable to health inequities.
  • Children with medical complexity (CMC) represent a subgroup of CSHCN requiring extensive medical services.
  • Existing research suggests disparities in health and healthcare access for CSHCN.

Purpose of the Study:

  • To compare healthcare inequities between children with medical complexity (CMC) and CSHCN without medical complexity.
  • To identify factors contributing to unmet healthcare needs among CMC.
  • To analyze the impact of race/ethnicity, language, insurance, and poverty on healthcare access for CMC.

Main Methods:

  • Secondary data analysis of the 2005-06 and 2009-10 National Survey of Children with Special Health Care Needs (CSHCN).
  • Examined prevalence, service use, and needs reported by families.
  • Focused on inequities related to race/ethnicity, primary language, insurance type, and poverty status.

Main Results:

  • Children with medical complexity were twice as likely to have unmet healthcare needs compared to CSHCN without medical complexity.
  • Among CMC, unmet needs were not significantly associated with primary household language, income, or Medicaid insurance.
  • Medical complexity emerged as a significant determinant of unmet healthcare needs.

Conclusions:

  • Medical complexity is a primary driver of unmet healthcare needs in children.
  • Healthcare access disparities for CMC are not solely explained by socioeconomic or demographic factors.
  • Targeted interventions addressing the unique needs of CMC are crucial for improving health equity.

Keywords:
Children’s HealthChronic CareDisparitiesMaternal And Child Health

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