Skip to main content

Advertisement

Log in

Factors Associated with Health Care Access for Mississippi Children with Special Health Care Needs

Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives: This purpose of the study was to examine the factors associated with access to routine care and to specialty care for Mississippi children with special health care needs (CSHCN). Methods: We analyzed data for Mississippi CSHCN from the 2001 National Survey of Children with Special Health Care Needs. Using a modified version of Andersen and Aday’s Behavioral Model of Health Services Use, we explored the relationship of independent variables (e.g., demographics, insurance, severity of illness) to dependent variables (did not obtain routine care, did not obtain specialty care). We conducted bivariate and logistic regression analyses using SAS and SUDAAN. Results: Based on self-reported data, with a 61% response rate, 66% of Mississippi CSHCN needed routine health care, and 52.8% needed specialty care. Of these children, 6.5% did not receive routine care and 9.3% did not receive specialty care. In a fully adjusted model, discontinuous insurance coverage was an important factor associated with not having obtained routine care (OR = 7.8; CI = 1.7–35.9) and specialty care (OR = 8.6; CI = 2.0–36.8). Children with a high illness severity rank were more likely to have not obtained routine care than children with a low rank (OR 1.4; CI = 1.1–1.9). Conclusions: It may be important to establish a health insurance safety net for families who lack insurance continuity since it appears that a lapse in insurance coverage impedes health care access. Further research is needed to understand the relationship between illness severity and lack of health care access, especially for children with special health care needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yu SM, Bellamy HA, Schwalberg RH, Drum MA. Factors associated with the use of preventive dental and health services among U.S. adolescents. J Adolesc Health 2001;29(6):395–405.

    Article  PubMed  Google Scholar 

  2. Newacheck PW, Mc Manus M, Fox HB, Hung Y-Y, Halfon N. Access to health care for children with special health care needs. Pediatrics 2000;105(4):760–6.

    Article  PubMed  Google Scholar 

  3. Newacheck PW, Hung Y-Y, Wright KK. Racial and ethnic disparities in access to care for children with special health care needs. Ambul Pediatr 2002;2(4):247–54.

    Article  PubMed  Google Scholar 

  4. Silver JE, Stein REK. Access to care, unmet health needs and poverty status among children with and without chronic needs. Ambul Pediatr 2001;1(6):314–20.

    Article  PubMed  Google Scholar 

  5. Mayer ML, Skinner AC, Slifkin RT. Unmet need for routine and specialty care: Data from the National Survey of Children with Special Health Care Needs. Pediatrics 2004;113(2):e109–15.

    Article  PubMed  Google Scholar 

  6. Yu SM, Nyman RM, Kogan MD, Huang ZJ, Schwalberg RH. Parent’s language of interview and access to care for children with special health care needs. Ambul Pediatr 2004;4(2):181–7.

    Article  PubMed  Google Scholar 

  7. Strickland B, McPherson M, Weissman G, Huang ZJ, Newacheck PW. Access to the medical home: Results of the National Survey of Children with Special Health Care Needs. Pediatrics 2004;113(5):1485–92.

    PubMed  Google Scholar 

  8. Lishner DM, Richardson M, Levine P, Patrick D. Access to primary health care among persons with disabilities in rural areas: A summary of the literature. J Rural Health 1996;12(1):45–51.

    PubMed  Google Scholar 

  9. Weller WE, Minkovitz CS, Anderson GF. Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data). Pediatrics 2003;112(3):593–603.

    Article  PubMed  Google Scholar 

  10. Ireys HT, Nelson RP. New federal policy for children with special health care needs: Implications for pediatricians. Pediatrics 1992;90(3):321–7.

    PubMed  Google Scholar 

  11. van Dyck P, Kogan MD, Heppel D, Blumberg SJ, Cynamon MC, Newacheck PW. The National Survey of Children’s Health: A new data resource. Maternal and Child Health Journal 2004;8(3):183–8.

    Article  PubMed  Google Scholar 

  12. van Dyck PC, McPherson M, Strickland B, Nesseler K, Blumberg SJ, Cynamon ML, Newacheck PW. The National Survey of Children with Special Health Care Needs. Ambul Pediatr 2002;2(1):29–37.

    Article  PubMed  Google Scholar 

  13. Blumberg SJ, Olson LM, Frankel M, Osborn L, Beers NS, Srinath KP, Giambo P. Design and operation of the National Survey of Children with Special Health Care Needs, 2001. National Center for Health Statistics; 2003. Report No.: 41.

  14. Aday LA, Andersen RM. A framework for the study of access to medical care. Health Serv Res 1974;9:208–20.

    PubMed  Google Scholar 

  15. Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter? J Health Social Behav 1995;36:1–10.

    Google Scholar 

  16. Proctor BD, Dalaker J. Poverty in the United States. Washington, DC: U.S. Printing Office; 2003. Report No.: P60–222. (Current Population Reports).

  17. Kaiser Family Foundation. Mississippi: Population distribution by metropolitan status, state data 2001–2002, U.S. 2002. http://www.statehealthfacts.kff.org: State Health Facts Online 2003.

  18. Kaiser Family Foundation. Mississippi: Population distribution by race/ethnicity, state data 2001–2002, U.S. 2002.(online) Available at: http://www.statehealthfacts.kff.org: State Health Facts Online 2003.

  19. Fujiura GT, Roccoforte JA, Braddock D. Costs of family care for adults with mental retardation and related developmental disabilities. Am J Men Retard 1994;99(3):250–61.

    Google Scholar 

  20. Newacheck PW, Halfon N. The financial burden of medical expenses for children. Med Care 1986;24(12):1110–6.

    PubMed  Google Scholar 

  21. Newacheck PW, McManus MA. Health care expenditures for adolescents. J Adolesc Health Care 1990;11:133–40.

    Article  PubMed  Google Scholar 

  22. Zlotnick C, Soman LA. The impact of insurance lapse among low-income children. Journal of Urban Health 2004;81(4):568–83.

    PubMed  Google Scholar 

  23. Short FS, Graefe DR. Battery-powered health insurance? Stability in coverage of the uninsured. Health Affairs 2003;22(6):244–55.

    Article  PubMed  Google Scholar 

  24. Dobalian A, Andersen RM, Stein JA, Hays RD, Cunningham WE, Marcus M. The impact of HIV on oral health and subsequent use of dental services. J Public Health Den 2003;63(2):78–85.

    Google Scholar 

  25. Gallagher TC, Andersen RM, Koegel P, Gelberg L. Determinants of regular source of care among homeless adults in Los Angeles. Med Care 2004;35(8):814–30.

    Article  Google Scholar 

  26. Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: Application to Medical care uses and outcomes for homeless people. HSR: Health Services Research 2000;34(6):1273–302.

    Google Scholar 

  27. Goodwin R, Andersen RM. Use of the behavioral model of health care use to identify correlates of use of treatment for panic attacks in the community. Soc Psychiatry Psychiatr Epidemiol 2003;37:212–9.

    Article  Google Scholar 

  28. Kilbourne AM, Andersen RM, Asch S, Nakazono T, Crystal S, Stein M, Gifford AL, Bing EG, Bozzette SA, Shapiro MF, Cunningham WE. Response to symptoms among a U.S. national sample of adults infected with human immunodeficiency virus. Med Care Res Rev 2004;59(1):36–58.

    Article  Google Scholar 

  29. SAS Institute Inc., SAS/STAT User’s Guide, Version 8. Cary, NC: SAS Institute Inc., 1999.

    Google Scholar 

  30. Research Triangle Institute, SUDAAN Example Manual, Release 9.0. Research Triangle Park, NC: Research Triangle Institute, 2004.

    Google Scholar 

  31. Research Triangle Institute, SUDAAN Language Manual, Release 9.0. Research Triangle Park, NC: Research Triangle Institute; 2004.

    Google Scholar 

  32. Sudano JJ Jr, Baker DW. Intermittent lack of health insurance coverage and use of preventive services. Am J Public Health 2003;93(1):130–6.

    PubMed  Google Scholar 

  33. Newacheck PW, Pearl M, Hughes DC, Halfon N. The role of Medicaid in ensuring children’s access to care. JAMA 1998;280(20):1789–93.

    Article  PubMed  Google Scholar 

  34. Yu SM, Bellamy HA, Kogan MD, Dunbar JL, Schwalberg RH, Schuster MA. Factors that influence receipt of recommended preventative pediatric health and dental care. Pediatrics 2002;110(6):e73–80.

    Article  PubMed  Google Scholar 

  35. Ahmed SM, Lemkau JP, Nealeigh N, Mann B. Barriers to healthcare access in a non-elderly poor American population. Health Soc Care Community 2001;9(6):445–53.

    Article  PubMed  Google Scholar 

  36. DeVellis RF. Guidelines in scale development. Scale Development-Theory and Applications. Newbury Park, CA: Sage Publications, Inc.; 1991. pp. 51–90.

  37. Pedhazur EJ, Schmelkin LP. Selected approaches to measurement in sociobehavioral research. Measurement, Design, and Analysis: An Integrated Approach. Hillsdale, New Jersey: Lawrence Erlbaum Associates, Inc.; 1991. pp. 118–46.

  38. Boyle CA, Decoufle P, Yeargin-Allsopp M. Prevalence and health impact of developmental disabilities in US children. Pediatrics 1994;93(3):399–403.

    PubMed  Google Scholar 

  39. Newacheck PW, Hughes DC, Wong ST, Stoddard JJ. The unmet health care needs of America’s children. Pediatrics 2000;(105):989–97.

  40. Newacheck PW, Wong ST, Galbraith AA, Hung AA, Hung Y-Y. Adolescent health care expenditures: A descriptive profile. J Adolesc Health 2003;32S(6S):3–11.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Debra J. Kane PhD, RN.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kane, D.J., Zotti, M.E. & Rosenberg, D. Factors Associated with Health Care Access for Mississippi Children with Special Health Care Needs. Matern Child Health J 9 (Suppl 2), S23–S31 (2005). https://doi.org/10.1007/s10995-005-3964-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-005-3964-9

Key Words

Navigation