Barriers to Care Among US School-Aged Children With Disabilities

Abstract

We examined financial barriers to care experienced by US school-aged children with disabilities. Data from the 2005 National Health Interview Survey were analyzed. Children aged 5 to 17 years were classified into 4 health condition groups: children with activity limitations, disabling conditions, chronic asthma, or no health conditions. Financial barriers to care were defined as being unable to afford prescriptions, delaying medical care, and/or having forgone medical care because of concern about cost. Our study included 8870 school-aged children; 338 children had an activity limitation, 1535 had a disabling condition, 594 children had chronic asthma, and 6288 children had no health conditions. Children with activity limitations were significantly more likely than children with no health conditions to experience all 3 financial barriers to care. Uninsured children with activity limitations, disabling conditions, or no health conditions had the highest prevalence of all financial barriers to care. Of children living greater than or equal to 200% Federal Poverty Level, children with activity limitations and disabling conditions were more likely than children with no health conditions to experience all 3 financial barriers to care. Multivariate analysis showed uninsured children (odds ratio, 7.40; 95% confidence interval, 5.28-10.37) and children with an activity limitation (odds ratio, 3.70; 95% CI, 2.37-5.76) were at highest risk for financial barriers to care. Uninsured and privately insured children with activity limitations were significantly more likely to experience financial barriers. The results show that many uninsured children still experience financial barriers to care despite the creation of the State Children's Health Insurance Program.