| Titre : | Health-care use and expenditures for children in special education with special health-care needs : Is dual classification a marker for high use ? (2007) |
| Auteurs : | SICES (Laura) : USA. Department of Pediatrics. Case Western Reserve University. Cleveland. OH. ; HARMAN (Jeffrey-S) : USA. Department of Health Services Research. Management. And Policy. College of Public Health and Health Professions. The University of Florida. Gainesville. FL. ; KELLEHER (Kelly-J) : USA. Department of Pediatrics. The Ohio State University. Columbus. OH. |
| Type de document : | Article |
| Dans : | Public health reports (vol. 122, n° 4, 2007) |
| Pagination : | 531-540 |
| Langues: | Anglais |
| Mots-clés : | Soins ; Utilisation ; Dépense ; Enfant ; Personne handicapée ; Handicap ; Classification ; Homme ; Amérique ; Maladie chronique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS ZZLsKR0x. Diffusion soumise à autorisation]. Objectives. Children with special health-care needs are an important group for policy and research planning. Special education engages a group of children with increased utilization of services related to education. While increased service utilization in education or health-care settings is often used to classify children as having special needs, considerable heterogeneity exists within each group. The extent to which being identified in two functionally defined systems-special education and health care-relates to health-care utilization is unknown. We sought to determine health-care and mental health utilization and expenditures for children dually classified as receiving special education and having special health-care needs (SHCN) compared with those who only have SHCN, only are in special education, or don't fall into either category. Methods. A nationally representative sample of children aged 5-17 years from the Medical Expenditure Panel Survey was used to compare mean health-care and mental health utilization and expenditures for the four groups. Results. Dually classified children had significantly higher mean utilization of health-care services than the other three groups (p<0.05). Mean 12-month total health-care expenditures were highest for dually classified children ($3,891/year) (p<0.05) and higher for children classified only as having SHCN ($1,426/year) than for children with neither classification ($644/year, p<0.05). Conclusions. Children dually classified as receiving special education and having SHCN represent a subgroup of children with SHCN with high levels of health-care utilization and expenditures. This information can assist policy makers in identifying characteristics that place children at risk for very high expenditures, and in allocating health-care resources. |
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