2015 APHA Annual Meeting & Expo

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Online Program

317922
Association between Health Care Access Quality Indicators and Emergency Department Use among Children with Developmental Disabilities in the US


Tuesday, November 3, 2015 : 4:50 p.m. - 5:10 p.m.

Sue Chienshy Lin, PhD MS, Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
Audio (mp3) recording Recorded Presentation (mp4)
Background/Significance: Children with developmental disabilities (DDs) are at risk for emergency room visits due to chronic medical needs.  Emergency department use (EDU) has increased in the US, with health care access as a key contributor. 

Objective/Purpose: The study examines the relationship between EDU and national health care access quality indicators among children with DD.

Method: Using cross-sectional data on children with DD (N=15,596) from the 2009-2010 National Survey of Children with Special Health Care Needs, we conducted bivariate chi-square and multivariate logistic regression analysis to ascertain the association between EDU and health care quality indicators of access to special health services and assistive technology, usual source of sick care, family-centered care, personal doctor or nurse, and family support service.

Results: Bivariate analysis yielded the following findings among those with higher EDU: 1) 23.8% had 2 or more unmet need for special health services and assistive technology versus 11% with lower EDU; 2) 17.2% had unmet needs for family support services versus 12.0%; 3) 5.7% were without a personal doctor or nurse versus 7.0%. Adjusted Odds Ratio (aOR) for those lacking access to family-centered care and usual source of sick care had higher odds of increased EDU (aOR=1.30, 95% Confidence Interval (CI) = 1.15, 1.48) and (aOR=1.47, 95% CI = 1.22, 1.78) respectively.

Discussion and Conclusion: Addressing the unmet needs of key health care access quality indicators may support the effective management of medical needs for children with DD in outpatient settings to reduce future EDU and associated health care costs.

Learning Areas:

Epidemiology
Public health or related public policy

Learning Objectives:
Identify health care access quality indicators associated with increased emergency department use Compare disparities in health care access among children with developmental disabilities with different frequencies of emergency department use

Keyword(s): Disabilities, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Sue is currently a Senior Advisor in the Bureau of Primary Health Care (BPHC), at the Health Resources and Services Administration (HRSA) and formerly an Extramural Research Program Officer at the Maternal and Child Health Bureau (MCHB) at HRSA with grantee portfolio in children with developmental disabilities. Prior to HRSA, she has worked at the national and state level on research, education, and service in public health and disabilities across the life span.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4410.0: Health care utilization among people with disabilities