AN EPIDEMIOLOGIC PROFILE OF CHILDREN WITH SPECIAL HEALTH-CARE NEEDS

Objective. To present an epidemiologic profile of children with specia l health care needs using a new definition of the population developed by the federal Maternal and Child Health Bureau. Methods. We operatio nalized the new definition using the recently released 1994 National H ealth Interview Survey on Disability. Estimates are based on 30 032 co mpleted interviews for children <18 years old. The overall response ra te was 87%. Results. Eighteen percent of US children <18 years old in 1994, or 12.6 million children nationally, had a chronic physical, dev elopmental, behavioral, or emotional condition and required health and related services of a type or amount beyond that required by children generally. This estimate includes children with existing special heal th care needs but excludes the at-risk population. Prevalence was high er for older children, boys, African-Americans, and children from low- income and single-parent households. Children with existing special he alth care needs had three times as many bed days and school absence da ys as other children. An estimated 11% of children with existing speci al health care needs were uninsured, 6% were without a usual source of health care, 18% were reported as dissatisfied with one or more aspec ts of care received at their usual source of care, and 13% had one or more unmet health needs in the past year. Conclusions. A substantial m inority of US children were identified as having an existing special h ealth care need using national survey data. Children with existing spe cial health care needs are disproportionately poor and socially disadv antaged. Moreover, many of these children face significant barriers to health care.