Developing a measure of unmet health care needs for a pediatric population

BACKGROUND. Quantified measures of unmet health care needs can be used to e valuate health care interventions, assess the impact of managed care, monit or health status trends in populations, or assess equity of access to medic al care across population subgroups. Such a measure needs to be simple, rel atively easy to obtain, inexpensive, and appropriately targeted to the popu lation of interest. OBJECTIVE. TO develop a measure of unmet health care needs that is specific ally targeted to a pediatric population. SUBJECTS. Study participants consisted of children, aged 1 to 5 years (n = 1,031), and adolescent mothers, aged 13 to 19 years (n = 172), predominantl y from poor, minority families in New York City. RESEARCH DESIGN. Based on a measure, the symptoms-response ratio, developed for all age groups, this study replicated Taylor's procedures specifically for children and adolescents. Respondents were asked if they had experienc ed a set of physical symptoms and if they saw a doctor in response. A panel of pediatricians rated the same symptoms as to whether health care should be sought. RESULTS. The measure achieved adequate inter-rater reliability and good con struct validity. The children's overall use of health services did not diff er from the pediatric panel's expectations, but with differing degrees of u nmet needs by symptom. Adolescents sought care less often than the expert p anel members believed they should. CONCLUSIONS. The symptoms-response ratio provides a good balance of a simpl e and inexpensive measure while yielding a fair estimate of unmet needs for primary care. This analysis created a pediatric measure targeted to the ne eds of young children and adolescent females.