Dataset Information

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

ABSTRACT:

Introduction

Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020.

Method

Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analysis.

Results

The final sample included 17,065 CYSHCN. In the fully adjusted analysis, there was a significant decrease in odds of accessing preventive dental care (adjusted odds ratio [AOR], 0.63; 95%confidence interval [CI], 0.51-0.77) and increased odds of unmet mental health care needs (AOR,1.34; 95% CI, 1.02-1.77). The inability to obtain an appointment was a barrier that increased during the study period (AOR, 2.77; 95% CI, 1.71-4.46).

Discussion

Novel pandemic related policies may have mitigated negative impacts on health care access for CYSHCN.

SUBMITTER: Gigli KH

PROVIDER: S-EPMC9489986 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

Gigli Kristin Hittle KH Graaf Genevieve G

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 20220921 2

<h4>Introduction</h4>Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020.<h4>Method</h4>Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analys ...[more]

PMID: 36216644

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Project description:IntroductionCaring for children and youth with special health care needs (CYSHCN) is a significant undertaking for families. While respite care is intended to address this burden, demand continues to exceed supply. Exploring the perspectives of respite service providers (SPs) and stakeholders (SKs) provides unique insight into families' needs and respite care systems.MethodsWe conducted semistructured interviews with 41 respite care SPs and SKs across four Canadian provinces to ascertain perspectives on current and ideal respite care for families of CYSHCN. The analysis included delineating units of meaning from the data, clustering units of meaning to form thematic statements and extracting themes. The second-level analysis involved applying themes and subthemes to cross-functional process maps.FindingsParticipants noted the critical, but sometimes absent role of Community Service Workers, who have the ability to support families accessing and navigating respite care systems. SPs and SKs identified current respite systems as operating in crisis mode. New findings suggest an ideal respite care system would incorporate advocacy for families, empower families and value CYSHCN, their families and respite workers.ConclusionThe evidence of unmet respite care needs of families of CYSHCN across Canada has long been available. Our findings identifying respite system challenges and solutions can be used by funders and policymakers for planning and enhancing resources, and by healthcare professionals, respite care providers and SKs to understand barriers and take action to improve respite outcomes to meet the respite needs of all families and CYSHCN.Patient or public contributionThe research team is composed of patients, researchers, clinicians and decision-makers along with our Family Advisory Committee (FAC) composed of members of families of CYSHNC. The FAC was formed and met regularly with research team members, knowledge users and collaborators throughout the study to provide input on design, review themes and ensure findings are translated and disseminated in a meaningful way.

Project description:AimPrevious studies have shown that children of caregivers with low oral health literacy (OHL) had more untreated caries than children of caregivers with adequate OHL. However, there is a paucity of information on this relationship among children and youth with special health care needs (CYSHCN). Accordingly, this study aims to assess the association between the caregivers' OHL and the oral health status of CYSHCN.MethodsThis cross-sectional study was conducted in four schools dedicated for CYSHCN. A 48-item questionnaire gathered information about the demographic and socioeconomic factors, the child/adolescent's medical condition, dental characteristics, caregiver self-efficacy and the child's dental attitude. The Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire was used to assess the caregivers' OHL. The Löe & Silness gingival index (GI) and the Silness & Löe plaque index (PI) were used to assess gingival health and plaque levels, respectively. Directed acyclic graphs (DAGs) were utilized for the selection of the appropriate set of confounding variables for regression analysis. The mean score differences and 95% confidence intervals (CI) were estimated to quantify the associations of the various covariates with oral health outcome variables.ResultsThis study included 214 child/caregiver dyads. Most participants were physically disabled (56.1%) followed by children with hearing difficulty (9.8%) and congenital anomalies/syndromes (7.9%). The mean PI and GI of the children was 1.26±0.52 and 1.30±0.47, respectively. The median CMOHK score was 12 and the respondents were dichotomized based on the median value. Low caregiver oral health conceptual knowledge was significantly associated with higher PI scores (β [95% CI] = -0.26 [-0.41, -0.13]; p<0.001. Older participants (12-21-year-olds) had significantly higher plaque scores compared with younger participants (6-12-year-olds) (β [95% CI] = 0.33 [0.18, 0.51]; p<0.001). Participants who brushed their teeth twice or more daily had significantly lower (β [95% CI] = -0.15 [-0.43, -0.01]; p = 0.046). Conceptual knowledge score was not significantly associated with GI.ConclusionThis study found lower caregiver OHL levels to be associated with higher plaque scores for their child.

Dataset Information

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

Introduction

Method

Results

Discussion

Publications

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

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