Health care costs higher for children with special health care needs

CHICAGO – Although children with special health care needs comprised less than 16 percent of the child population, they had health care expenditures three times higher than other children, according to an article in the January issue of The Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, children with special health care needs (CSHCN) are defined as "those children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." Compared to other children, CSHCN use more health care services and thus have higher health care costs.

Paul W. Newacheck, Dr.P.H., from the Institute for Health Policy Studies, University of California, San Francisco, and colleagues used data from the 2000 Medical Expenditure Panel Survey (MEPS) in order to examine health care expenditures of CSHCN. A total of 6,965 children under the age of 18 were included in the survey, with 949 (15.6 percent) identified as CSHCN. From these data the number of CSHCN in the U.S. was estimated at 11 million.

In 2000, CSHCN had an average health care expenditure of $2,099, compared to children without special health care needs who had an average expenditure of $628. CSHCN accounted for 42.1 percent of total medical care costs (excluding dental costs) and 33.6 percent of total health care costs (including dental costs) for children. These children also had more than twice as many physician visits and seven times as many non-physician visits than other children, and had average out-of-pocket costs (for all health care) twice that of other children ($352 vs. $174). Average annual expenditures on prescribed medications were ten times higher ($340 vs. $34) for CSHCN.

"Our results show that CSHCN use many more services and have significantly higher health care expenses than other children," the authors write. "Health policy changes that would extend the breadth and depth of insurance coverage are needed to ensure that all families of CSHCN are protected against burdensome expenses."

(Arch Pediatr Adolesc Med. 2005; 159: 10 – 17. Available post-embargo at www.archpediatrics.com)

Editor's Note: This study was supported by a cooperative agreement from the federal Maternal and Child Health Bureau, Rockville, Md., and a consulting agreement with the Agency for Healthcare Research and Quality, Rockville.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

To contact Paul W. Newacheck, Dr.P.H., call UCSF News Services at 415-476-2557.

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