Indiana Children's Special Health Care Services program: Impact of administrative changes on health care utilization, access to care, and unmet needs

In this study we assessed the impact of administrative changes occurring in 1993 on the Indiana Children's Special Health Care Services program. Respo nses from a 1994-1995 survey were compared with a 1991 survey. Unmet needs declined in 6 categories: primary medical care, hospital services, home nur sing care, physical therapy, occupational therapy, and special equipment. U nmet needs remained the same in categories: specialty care, speech therapy, respite care, parent support, child support, and sibling support. Unmet ne eds increased in 5 categories: dental care, mental health, transportation, housing modifications, and child and day care. Although program changes imp roved the health care needs of clients in many areas, additional efforts ar e still needed.