Operationalizing a conceptually based noncategorical definition - A first look at US children with chronic conditions

Objective: To apply a conceptually based noncategorical definition in the a nalysis of a nationally representative sample of US children to determine t he prevalence and sociodemographic characteristics of US children with chro nic conditions. Design: Data on 30 032 children, aged 0 through 17 years, from the 1994 Nat ional Health Interview Survey Disability Supplement were analyzed using a n oncategorical conceptual definition of chronic conditions and a method that parallels that outlined in the development of the Questionnaire for Identi fying Children with Chronic Conditions. We determined the percentages of ch ildren with chronic conditions overall and in 3 conceptual domains: (I) fun ctional limitations, (2) dependence on compensatory mechanisms, and (3) ser vice use or need beyond routine care for age. Results: Content that corresponded to 35 of 39 items on the Questionnaire f or Identifying Children with Chronic Conditions assessing consequences was available in the National Health Interview Survey Disability Supplement dat a set. An estimated 10.3 million children (14.8%) had chronic conditions; 7 .0% of the children met enrollment criteria in a single conceptual domain, 5.2% in 2 domains, and 2.6% in all 3 domains. Significant sociodemographic correlates of having a chronic condition were being school-aged or older, m ale, white, living with a responsible adult with less than a college educat ion, and having a family income below the poverty index tall P<.01). Conclusions: We established the feasibility of operationalizing a noncatego rical conceptual definition by using a large-scale data set and provided an estimate of the prevalence of chronic conditions among US children. We con firmed that several sociodemographic correlates of chronic conditions in sa mples identified through diagnostic checklists were related to the presence of chronic conditions among these children.