The utilization of medical and health-related services among children with chronic conditions

Problem statement. Although many children with chronic conditions use a range of medical and health-related services, few empirical studies have examined the utilization of services beyond routine medical care. This study begins to address gaps in knowledge by analyzing the utilization of four medical and six health-related services among children with chronic conditions who were between the ages of 5 and 17.; Specifically, the Purpose of this study was threefold: to describe the utilization of medical and health-related services among children with chronic conditions; to examine the association between predisposing, enabling, and need factors and variations in medical and health-related service use among children with chronic conditions; and to determine the correlation between medical and health-related service use.; Methods. Study design/data source. Cross-sectional study using data from Phases 1 and 2 of the 1994 National Health Interview Disability Survey (NHIS-D).; Sample population. A total of 3 061 children between the ages of 5 and 17 who met a non-categorical definition of chronic conditions (the Questionnaire for Identifying Children with Chronic Conditions operationalized for use with the NHIS-D) and who completed both the Phase 1 and Phase 2 surveys.; Outcome measures. Percentage of children using any of four medical services (physician, hospital, emergency room, and mental health outpatient) and six health-related services/items (therapeutic, social work, assistive devices, care coordination, housing modifications, and transportation); mean use among children who used a given medical or health-related service.; Analytic approach. Based on the Aday and Anderson Access Framework, associations between child and family characteristics and utilization of medical and health-related factors were examined. Specifically, multiple logistic regression was used to analyze the association between predisposing, enabling, and need factors and the likelihood of service use, controlling for the effect of other variables. Multiple linear regression was used to analyze the association between predisposing, enabling, and need factors and the volume of utilization given any service use. Chi-square tests and Spearman-rank correlations were used to assess the correlation between the use of medical and health related services.; All analyses were conducted using both SAS and SUDAAN, a statistical software package that accounts for the complex, multistage sampling frame of the survey. Analyses were first performed on raw survey data and then reanalyzed using a weighted variable to reflect national estimates. (Abstract shortened by UMI.)...