Health insurance and utilization of medical care for children with special health care needs

Lu Ann Aday, Eun Sul Lee, Bill Spears, Chih Wen Chung, Adel Youssef, Barbara Bloom

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Based on analyses of the 1988 National Center for Health Statistics, National Health Interview Survey, Child Health Supplement, this study examines the insurance coverage and utilization of physicians, hospitals, and prescribed medicine among the 9.6 million U.S. children with special health care needs, defined as children who had one or more selected chronic conditions that caused them to experience pain, discomfort, or being upset often or all of the time in the last year, or who were limited in their major childhood activities (playing or going to school) as a result of these or other impairments or health problems. The findings confirmed that substantial variation in access to routine medical care exists among these children. Though health status is an important predictor of which children use services in general, poor, minority children who lived with their mother or someone other than their parents, or those without insurance or an identifiable regular medical provider were most likely to experience financial barriers to access or were less apt to seek care than other children with comparable needs. Access to routine medical care remains particularly problematic for these subsets of children with special health care needs.

Original languageEnglish (US)
Pages (from-to)1013-1026
Number of pages14
JournalMedical care
Issue number11
StatePublished - Nov 1993
Externally publishedYes


  • Children
  • Insurance
  • Utilization

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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