Table 1. Percentage of cases with unmet healthcare needs and % with specified reasons for unmet need, by type of service, a 2005-2006 National Survey of Children with Special Health Care Needs (CSHCN).
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Types of service
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Care of the child
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Family Care
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| Routine prevent care | Speclst care | Prevent dental | Other dental | Rx meds | Mental health | Subs abuse trtmnt b | Phys/occ / speech therapy | Family mental health | Genetic counsel | Respite care | ||||||
| # cases w/ need for service c | 31,136 | 20,955 | 33,447 | 10,229 | 34,839 | 10,027 | 755 | 8,939 | 4,878 | 2,159 | 1,763 | |||||
| # cases with unmet need | 710 | 1,096 | 2,332 | 969 | 578 | 1,458 | 161 | 1,118 | 946 | 463 | 804 | |||||
| % of all CSHCN who had any need a , d | 1.9 | 2.8 | 6.3 | 2.6 | 1.6 | 3.7 | 0.4 | 3.1 | 2.4 | 1.4 | 2.2 | |||||
| % of CSHCN who needed this service and had unmet need a , e | 2.4 | 5.4 | 7.7 | 10.6 | 1.8 | 14.8 | 20.7 | 13.5 | 19.3 | 23.8 | 47.8 | |||||
| Reasons for unmet need f , g | % of those with unmet need for the specified service, who reported the listed reason a , h | |||||||||||||||
| Coverage | ||||||||||||||||
| Cost too much | 29.8 | 21.4 | 29.3 | 42.1 | 47.7 | 21.6 | 12.8 | 15.1 | 34.1 | 17.2 | 25.7 | |||||
| Health plan problem | 15.6 | 17.6 | 14.6 | 14.0 | 37.1 | 13.0 | 5.6 | 21.7 | 12.6 | 10.9 | 8.2 | |||||
| Can’t find provider who accepts insurance | 3.2 | 7.1 | 9.0 | 8.2 | 2.7 | 7.0 | 7.2 | 3.5 | 5.1 | 3.8 | 6.0 | |||||
| Health system delivery problems | ||||||||||||||||
| Not convenient times/ couldn’t get appointment | 11.5 | 12.3 | 10.1 | 8.9 | 1.9 | 7.5 | 5.8 | 6.3 | 10.9 | 7.2 | 5.0 | |||||
| Dissatisfaction w/ provider | 7.3 | 8.3 | 3.8 | 1.9 | 4.4 | 9.7 | 8.5 | 6.9 | 5.3 | 7.6 | 4.0 | |||||
| Not available in area/ transportation problem | 5.6 | 11.9 | 6.2 | 7.3 | 1.5 | 10.6 | 14.7 | 12.3 | 7.4 | 10.3 | 29.7 | |||||
| Doctor didn’t know how to treat or provide care | 3.2 | 10.2 | 3.1 | 2.1 | 5.2 | 5.3 | 2.3 | 2.1 | 4.2 | 8.1 | 5.2 | |||||
| Didn’t know where to go for treatment | 3.2 | 6.6 | 4.3 | 3.6 | 1.7 | 7.2 | 7.6 | 3.2 | 7.8 | 12.8 | 11.5 | |||||
| No referral | 0.9 | 3.5 | 0.6 | 1.6 | 2.5 | 1.6 | 0.5 | 1.8 | 1.4 | 1.5 | 2.5 | |||||
| No insurance b | 30.6 | 15.7 | 22.0 | 21.8 | 23.3 | 12.3 | 6.9 | 6.7 | 16.4 | 11.1 | 6.1 | |||||
a Weighted to population level with weights provided by Blumberg et al. 2008 [26].
b Substance abuse question was not asked of 11,732 children aged 7 years and younger with valid data on covariates, so they are excluded from this column.
c Unweighted N.
d Denominator is all CSHCN with at least one reported service need of any kind; N= 39,582.
e Percentage of respondents with unmet need for that service. Denominator is those who stated a need for that service.
f Reasons that were not about coverage or health system delivery factors, or that pertained to only certain services, are included in the percentage of cases with unmet need (row 2) but are not broken out in detail. These include neglected/forgot appointment; treatment is ongoing; child refused to go; lack of resources at school; sick/other health issues more important; chooses not to vaccinate; didn't need/child in good health; need dentist for CSHCN; too busy/thought not important; child too young; child not at school to receive; school refused to provide; did not ask for it; vaccine shortage; and “other”
g Denied coverage, didn’t know about it, and program underfunded or difficult to obtain were offered as reasons only for respite care; they are included in prevalence of unmet need but not shown separately.
h Each respondent could report more than one reason for unmet need for each type of service.
i Excluded from “coverage” category of reasons because it is too closely related to the independent variables used to measure service delivery. See text for more detail.