Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs

Myra Rosen-Reynoso, Michelle V. Porche, Ngai Kwan, Christina Bethell, Veronica Thomas, Julie Robertson, Eva Hawes, Susan Foley, Judith Palfrey

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objectives Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009–2010) and using the revised criteria for “ease of use,” we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. Methods We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the “ease of use” criteria with socio-demographic, complexity of need, and access variables. Results Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. Conclusions for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources.

Original languageEnglish (US)
Pages (from-to)1041-1053
Number of pages13
JournalMaternal and child health journal
Issue number5
StatePublished - May 1 2016


  • Disparities
  • Medical home
  • Special-needs children
  • Survey

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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