Table 3.
Adjusted Associationsa of Adverse Family Financial and Employment Impacts and Child Behavioral Functioning Problems with Unmet Need for Child or Family Health Services Among US Children with Developmental Disabilities
| Family paid >$1,000 in annual out-of-pocket medical expenses | Family experienced financial problems due to the child’s health condition | Family member cut-back or stopped working due to the child’s health condition | Family member avoided changing jobs to maintain the child’s health insurance | Child’s family spent ≥11 hours per week providing/coordinating care for the child | Child behavioral functioning problemsb | |
|---|---|---|---|---|---|---|
| aOR (95% CI): Any unmet need for child health services (n = 1,287) |
1.81 (1.35 – 2.41) |
2.98 (2.25 – 3.96) |
1.83 (1.37 – 2.43) |
1.64 (1.22 – 2.21) |
1.75 (1.27 – 2.41) |
1.19 (0.88 – 1.61) |
| aOR (95% CI): No unmet need for child health services (n = 2,665) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| aP-value | < .001 | < .001 | < .001 | .001 | .001 | .26 |
|
| ||||||
| aOR (95% CI): Any unmet need for family health services (n = 675) |
2.02 (1.40 – 2.91) |
4.81 (3.36 – 6.88) |
2.91 (1.99 – 4.26) |
1.90 (1.34 – 2.69) |
2.69 (1.82 – 3.96) |
1.37 (0.97 – 1.94) |
| aOR (95% CI): No unmet need for family health services (n = 3,342) |
1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| bP-value | < .001 | < .001 | < .001 | < .001 | < .001 | .08 |
Abbreviations: aOR, adjusted odds ratio; CI, confidence interval.
Odds ratios were adjusted for child age, sex, race/ethnicity, household income level, health insurance type, region of residence, highest parent education level, family structure, developmental disability type, functional limitations status, and condition comorbidity.
Models were additionally adjusted for whether or not children experienced serious overall difficulty in terms of having a lot of difficulty with any of the following: (1) learning, understanding, or paying attention; (2) speaking, communicating, or being understood; (3) feeling anxious or depressed; or (4) behavior problems, such as acting-out, fighting, bullying, or arguing.
Source: 2011 Survey of Pathways to Diagnosis and Services linked to the 2009–10 National Survey of Children with Special Health Care Needs