Study Provides New Data on Infants and Children with Special Health Care Needs

April 23, 2008

"As demonstrated in earlier studies, CSHCN [children with special health care needs] require and use more health care services, as well as incur higher expenses. Our analysis shows that this also holds true for IYCSHCN [infants and young children with special health care needs]," state the authors of an article published in the April-June 2008 issue of Infants and Young Children: An Interdisciplinary Journal of Special Care Practices. Although multiple studies have evaluated heath care expenditures for children with specific conditions, there is a paucity of data addressing health care utilization and costs for young CSHCN.

This study describes the prevalence of special health care needs in infants and young children (from birth to age 5) and delineates their health care utilization, access, and expenditures, with an emphasis on financial burden on families.

Data for the study were drawn from the 2001 and 2002 Medical Expenditure Panel Surveys. The sample for the present study included 6,677 infants and children, all of whom were identified as having or not having a special health care need using the CSHCN screener. The analysis calculated expenses for hospital inpatient and outpatient services, physician services, dental services, services provided by health professionals other than physicians, prescribed medication, diagnostic tests, and certain types of medical equipment and supplies for all individuals in the sample. Determinants of access to health care (unmet needs, satisfaction) were also assessed and stratified by special needs status. Payments were distinguished as either out-of-pocket costs to families or from third-party payers, and the financial burden of out-of-pocket expenses was measured.

The authors found that:

  • Approximately 11% of infants and young children from birth to age 5 had an identified special health care need.
  • IYCSHCN were more likely than their peers without special health care needs to have an identified usual source of care; to have unmet needs for prescription medication, medical care, and urgent care; and to have problems seeing a specialist.
  • IYCSHCN used significantly more medical services than their age-matched peers.
  • Total yearly health care expenditures for IYCSHCN were significantly higher than those of their peers without special health care needs ($2,923 vs. $770).
  • An estimated 10.5% of families with an infant or young child with special health care needs paid more than $500 over the course of a year for health care expenses, whereas only 2.8% families of with an infant or young child with no special health care needs did so.

"Despite the numerous programs available to IYCSHCN, . . . families often experience high out-of-pocket expenses for services," state the authors. They conclude that "as our understanding of the health care needs for IYCSHCN improves, our ability to serve them will be enhanced."

Houtrow AJ, Kim SE, Newacheck P. 2008. Health care utilization, access, and expenditures for infants and young children with special health care needs. Infants and Young Children: An Interdisciplinary Journal of Special Care Practices 21(2):149-159. Abstract available here.

More information is available from the following MCH Library.