Health care access for children with special health care needs in California.

Abstract:

OBJECTIVES:This study examines health care access for children with special health care needs (CSHCN) in California, one of the nation's most populous and diverse states. METHODS:Data are from the National Survey of Children with Special Health Care Needs (NS-CSHCN), a nationally representative survey of access for U.S. children fielded by the National Center for Health Statistics (NCHS). California CSHCN and those in California's Medicaid program are compared with CSHCN elsewhere on child health need, family enabling factors, health care enabling factors, system outcomes, and children's experiences with care. Multivariable analysis identifies family and health care factors associated with system outcomes and children's experiences with health care. RESULTS:California parents generally report poorer experiences with care, lower performance on systems outcomes, and fewer health care and family enabling factors. The magnitude of disparity is greatest for CSHCN in Medi-Cal, although lower-income privately insured CSHCN in California also have poorer access than their counterparts in other states. Among CSHCN in Medicaid, greater condition impact and adolescent age are associated with poorer experiences in California for most measures. Disparities between California and other states persist even adjusting for family and health care factors in multivariable analysis. CONCLUSIONS:Performance gaps in California stem from population differences and apparent administrative barriers. Several statewide initiatives are addressing system barriers through supports to providers and information to parents.

journal_name

Matern Child Health J

authors

Inkelas M,Smith KA,Kuo AA,Rudolph L,Igdaloff S

doi

10.1007/s10995-005-4351-2

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

S109-16

issue

2 Suppl

eissn

1092-7875

issn

1573-6628

journal_volume

9

pub_type

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