Unmet Need for Therapy Services, Assistive Devices, and Related Services: Data From the National Survey of Children With Special Health Care Needs

Dusing, Stacey C.; Skinner, Asheley Cockrell; Mayer, Michelle L.

doi:10.1367/A03-202R1.1

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Volume 4, Issue 5 , Pages 448-454, September 2004

Unmet Need for Therapy Services, Assistive Devices, and Related Services: Data From the National Survey of Children With Special Health Care Needs

Stacey C. Dusing, PT, MS
- From the Program in Human Movement Science, Division of Physical Therapy (Ms Dusing), the Department of Health Policy and Administration (Ms Cockrell Skinner), and the Cecil G. Sheps Center for Health Services Research (Dr Mayer), University of North Carolina, Chapel Hill, Chapel Hill, NC
Asheley Cockrell Skinner, BA
- From the Program in Human Movement Science, Division of Physical Therapy (Ms Dusing), the Department of Health Policy and Administration (Ms Cockrell Skinner), and the Cecil G. Sheps Center for Health Services Research (Dr Mayer), University of North Carolina, Chapel Hill, Chapel Hill, NC
Michelle L. Mayer, PhD, MPH, RN
- Address correspondence to Michelle L. Mayer, PhD, MPH, RN, Department of Health Policy and Administration, Cecil G. Sheps Center for Health Services Research, CB 7590, Chapel Hill, NC 2759-7590

Received 30 December 2003; accepted 14 May 2004.

Objective.—To estimate the prevalence of unmet needs for therapy services, vision and hearing care or aids, mobility aids, and communication aids and to investigate the association between predisposing, enabling, need, and environmental factors and unmet needs.

Methods.—Using the National Survey of Children with Special Health Care Needs, we generated national prevalence estimates and performed bivariate and logistic analyses, accounting for the complex survey design.

Results.—Nationally, the prevalence of unmet needs ranged from 5.8% among children with special health care needs (CSHCN) with a reported need for vision care or glasses to 24.7% among CSHCN with a reported need for communication aids. In logit analyses, CSHCN without insurance coverage were significantly more likely to have a reported unmet need for therapy services (adjusted odds ratio [OR]: 2.08, confidence interval [CI]: 1.39–3.12), vision care or glasses (OR: 3.94, CI: 2.64–5.86), and mobility aids (OR: 5.17, CI: 1.86–14.37). Children in families at or below 100% of the federal poverty level were significantly more likely to have a reported unmet need for vision care or glasses (OR: 4.51, CI: 2.86–7.12) and hearing aids or hearing care (OR: 3.61, CI: 1.70–7.65). For each of the services studied, more-severely limited children were significantly more likely to have an unmet need reported.

Conclusion.—Our findings demonstrate that a minority of CSHCN have unmet needs for therapy services, assistive devices, and related services. Parents of children with more-severe ability limitations were more likely to report having unmet needs. Our findings highlight the importance of insurance coverage in ensuring access to therapy services, assistive devices, and related services.

KEY WORDS: access to care , assistive devices , insurance , therapy