Children with special health care needs: with population-based data, better individual care plans.

Abstract

Children with special health care needs (CSHCN) represent 15% to 20% of all US children.1 Several studies have documented well the substantial health care utilization,2 school problems,3 and family financial costs,4 as well as decreased parental workforce participation5,6 and worse caregiver well-being6 for CSHCN generally and for a subset with more complex medical conditions. These effects are somewhat attenuated but not eliminated when families have access to practice-level primary care medical home programs7 and programs specifically targeting children with complex chronic conditions,8 and when stronger state-level safety net policies are in place.9,10 In this issue of Pediatrics , Quach et al11 accomplish 2 important goals that help to inform programs and policies to support families in caring for CSHCN using longitudinal population cohort surveys that incorporate the Children with Special Health Care Needs Screener. Quach and colleagues describe 4 distinct trajectories of having a special health care need (no special health care need and transient, emerging, … Address correspondence to Jeanne Van Cleave, MD, 100 Cambridge St, 15th Floor, C100, Boston, MA 02114. E-mail: jvancleave{at}partners.org