Immigrant Families, Children With Special Health Care Needs, and the Medical Home

Kan, Kristin; Choi, Hwajung; Davis, Matthew M.

doi:10.1542/peds.2015-3221

Cited by 26 publications

(27 citation statements)

References 28 publications

(38 reference statements)

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“…6,[8][9][10][11][12] Prior studies describing care coordination use among CSHCN have noted a wide range of socioeconomic disparities in access to care coordination, including differences by race, insurance status, family structure, nativity, and language spoken in the home. [8][9][10][11][12][13] The present study multivariable analysis identified none of these disparities as determining the likelihood of met rather than unmet need for care coordination. Recent technological developments and health care reforms may have eased implementation of care coordination services and incentivized providers to coordinate patients' care, contributing to the absence of disparities.…”

Section: Discussionmentioning

confidence: 68%

“…[21][22][23] Previous studies have described disparities in access to care coordination among CSHCN according to race, insurance coverage type, family income, and national origin. [8][9][10][11][12][13] Given recent growth in care coordination initiatives, this study aimed to estimate the prevalence and disparities of unmet need for care coordination among CSHCN using the most recent available national data. In this study, 36% of CSHCN had a caregiver-reported need for care coordination, yet only 58% of this group reported receiving adequate help.…”

Section: Discussionmentioning

confidence: 99%

“…Child and household characteristics were selected based on prior studies examining care coordination disparities. [8][9][10][11][12][13] Child characteristics included sex, race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, or other), age (0-5, 6-11, or 12-17 years), presence of a mental health condition (including attention deficit hyperactivity disorder, depression, anxiety, or conduct disorder), insurance type (private, public, other, or none), and whether the child was born in the United States. Household characteristics included household income (<100%, 100%-199%, 200%-399%, or ‡400% of the federal poverty line [FPL]), whether English was the primary language spoken at home, family structure (2-parent household, mother-only household, or other), and highest education level achieved by either parent (high school or less, some college [including trade school or associate degree], bachelor degree, or postgraduate education).…”

Section: Methodsmentioning

confidence: 99%

“…7 However, access to care coordination appears to be unequal, with specific disparities noted across race, insurance status, family structure, chronic condition type, language spoken at home, and immigration status. [8][9][10][11][12][13] Understanding the need for care coordination among CSHCN, as well as the extent to which this need remains unmet, can help clarify clinical and administrative challenges in caring for these patients.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Unmet Need for Care Coordination Among Children with Special Health Care Needs

Miller

Tumin

Hayes

et al. 2019

Population Health Management

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Socioeconomic disparities in access to care coordination have been noted among children with special health care needs (CSHCN). Following recent policy developments and technological innovation, care coordination has become more widespread, possibly leading to reduced disparity in care coordination access. This study investigates whether child and household characteristics remain associated with unmet need for care coordination among CSHCN. CSHCN (aged <18 years) requiring ‡2 types of health services in the past year were identified in the 2016 National Survey of Children's Health (NSCH). Care coordination was defined as help with arranging the child's care among different doctors or services. Children were classified as not needing care coordination, receiving sufficient care coordination (met need), or needing but not receiving care coordination (unmet need). Weighted multinomial logistic regression examined the association of child characteristics with this outcome. The analysis included 5622 children with no need for care coordination, 1466 with a met need, and 980 with unmet needs. Children with mental health conditions were more likely to have unmet rather than met needs for care coordination (odds ratio = 4.1; 95% confidence interval: 2.7, 6.1; P < 0.001). After multivariable adjustment, race/ethnicity, income, family structure, insurance coverage, place of birth, and use of English in the home were not associated with having unmet rather than met needs for care coordination. Among CSHCN, the latest data from NSCH reveal no evidence of previously described socioeconomic disparities in access to care coordination. Nevertheless, unmet needs for care coordination remain prevalent, especially among children with mental health conditions.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unmet Need for Care Coordination Among Children with Special Health Care Needs

Miller

Tumin

Hayes

et al. 2019

Population Health Management

View full text Add to dashboard Cite

show abstract

“…3 Furthermore, CSHCN who are foreign born or whose parents are foreign born are less likely to have a medical home than CSHCN with US-born parents. 8 Because resident continuity clinics typically offer care to disadvantaged populations, improved care of CSHCN in this setting may offer an opportunity to mitigate health disparities.…”

Section: Academic Pediatricsmentioning

confidence: 99%

Enhancing Resident Education and Optimizing Care for Children With Special Health Care Needs in Resident Continuity Clinics

Linton¹,

Reichard

Peters

et al. 2018

Academic Pediatrics

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Examining factors related to the age of diagnosis of children with autism spectrum disorder from immigrant and non‐immigrant backgrounds in a diverse clinical sample

Vanegas

2021

Autism Research

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A timely diagnosis of autism spectrum disorder (ASD) is important for children as that may help inform the best services and supports needed for optimal outcomes. However, disparities in the identification of ASD have been consistently documented for racial/ethnic minority and immigrant populations. The majority of studies of immigrant populations have focused on the qualitative experience of ASD, however, greater knowledge about the predictors of the age of initial ASD diagnosis is needed. This study examined the child, maternal, and family‐level factors that predicted the age of initial ASD diagnosis in a diverse clinical sample through a retrospective medical record review. Medical records of clinical evaluations conducted between 2004 and 2014 were reviewed for children with ASD born to immigrant and non‐immigrant mothers. Regression analyses found that for both groups of children with ASD, using verbal language to communicate and having another diagnosis (attention‐deficit/hyperactivity disorder or another condition) predicted an older age of initial ASD diagnosis. For children with ASD born to immigrant mothers, residing in a multilingual household was associated with a younger age of diagnosis. These results highlight the complexities of an ASD diagnosis among diverse children and families, particularly among immigrant communities. Lay Summary This research looked at predictors of when children received their first autism spectrum disorder diagnosis across children born to immigrant mothers and children born to U.S.‐born mothers. Living in a multilingual home was related to a younger age of diagnosis for children of immigrant mothers; being verbal and having another diagnosis was related to an older age of diagnosis for both groups of children. This highlights the need to improve diagnostic services for diverse children.

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Immigrant Families, Children With Special Health Care Needs, and the Medical Home

Cited by 26 publications

References 28 publications

Unmet Need for Care Coordination Among Children with Special Health Care Needs

Unmet Need for Care Coordination Among Children with Special Health Care Needs

Enhancing Resident Education and Optimizing Care for Children With Special Health Care Needs in Resident Continuity Clinics

Examining factors related to the age of diagnosis of children with autism spectrum disorder from immigrant and non‐immigrant backgrounds in a diverse clinical sample

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