Skinner AC, Mayer ML; AcademyHealth. Meeting (2004 : San Diego, Calif.).
Abstr AcademyHealth Meet. 2004; 21: abstract no. 1157.
University of North Carolina at Chapel Hill, Health Policy and Administration, CB #7411, Chapel Hill, NC 27599-7411 Tel. 336-392-5021 Fax 919.966.3811
RESEARCH OBJECTIVE: Unmet health needs are often used as measure of access; however, individual self-reports of need may not accurately reflect true need. Wide variations in health care needs among children with special health care needs (CSHCN) make comparisons of parental reports of need and true need difficult for medical services. However, the American Academy of Pediatrics (AAP) guidelines for dental care among CSHCN establish minimum required dental care for CSHCN over the age of one. We examine the validity of the parental perceived need for dental care among CSHCN by comparing prevalence estimates of need based on these measures and by identifying factors, other than measures of need, that affect the likelihood of reporting a need for care. STUDY DESIGN: Using data from the National Survey of Children with Special Health Care Needs, we performed bivariate and logistic regression analyses of perceived need for dental care and environmental, predisposing, and enabling factors. POPULATION STUDIED: CSHCN surveyed in the National Survey of Children with Special Health Care Needs (n=37,764). Our analyses are restricted to children over the age of one. PRINCIPAL FINDINGS: While the AAP recommends a dental visit for all CSHCN over the age of 1, we find that only 79.1% of parents report a perceived need for dental care. Results show that those most likely to report no need for dental care are children who are younger (aOR=29.16, p<.01, for one-year-old children; aOR=1.88, p<.01, for children aged four to five) and poor (aOR=1.38, p<.01). Compared to privately insured children, uninsured children are significantly less likely to have a reported need for dental care (aOR=1.69, p<.01). African-American (aOR=1.26, p<.001) and Hispanic (aOR=1.26, p<.05) children were significantly less likely to have a reported need for dental care than their white and non-Hispanic counterparts, respectively. Compared to children whose mothers had a college degree, those whose mothers have less than 12 years of education (aOR=2.14, p<.001) or only a high school diploma (aOR=1.70, p<.01) were less likely to report a need for dental care. Children who live in rural areas were less likely than those in metropolitan areas to have a reported need for dental care. (aOR=1.23, p<.01). CONCLUSIONS: Overall, parents underestimate their children's need for dental care relative to the AAP guideline for CSHCN. While parents of young children are significantly more likely to underestimate need, parents of other socially vulnerable children also underestimate need even when the model statistically controls for the child's age. When examining unmet need for dental care it is important to consider how parental perceptions affect receipt of care. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Although this study focuses only on dental care, it raises concerns about the validity of commonly-used measures of perceived need for other types of care as well. Because reports of unmet need are often based on self-reports, the validity of self-perceptions of need will also affect the measurement of unmet need for care. Improving access to dental care will require consideration of both traditional access issues as well as perceptions of need.
Publication Types:
Keywords:
- Child
- Child Health Services
- Data Collection
- Dental Care
- Family
- Health Care Surveys
- Health Services Needs and Demand
- Hispanic Americans
- Hospitals, Chronic Disease
- Humans
- Interviews as Topic
- Medically Uninsured
- Needs Assessment
- Parents
- Poverty
- methods
- hsrmtgs
UI: 103624191
From Meeting Abstracts