Special services including physical, occupational, speech, or behavioral therapies are associated with enhanced long-term functioning and well-being of children and youth with special healthcare needs (CYSHCN). Yet, there is a lack of recent evidence on the utilization of these services, and the age at which CYSHCN first receive them. This study assessed the distribution, timing, and determinants of special services utilization across different types of special healthcare needs. Data from 63,734 caregivers of CYSHCN aged 0–17 years from the 2016–2022 National Survey of Children's Health were analyzed using Rao-Scott Chi-Square, Log-rank, and Cox proportional hazard tests. Overall, 41.9 % of CYSHCN ever received special services, including 91.4 %, 90.3 %, 88.0, and 34.1 % of children and youth with Down syndrome, cerebral palsy, autism, and other special healthcare needs (OSHCN), respectively. Children with Down syndrome and cerebral palsy received special services earlier than those with autism or OSHCN. Utilization of special services was higher among male children and youth (aHR 1.41; 95 % CI: 1.33–1.49), aged 0–5 years (aHR: 4.70; 95 % CI: 4.32–5.11), second or later born children (aHR: 1.18; 95 % CI: 1.10–1.26), from families with low-income (aHR: 1.14; 95 % CI: 1.04–1.24), living with married parents (aHR: 1.11; 95 % CI: 1.04–1.19), consistently insured (aHR: 1.24; 95 % CI: 1.08–1.42), and with a more complex health condition (aHR: 3.40; 95 % CI: 3.13–3.70) compared to their counterparts. These findings highlight the necessity of adopting tailored approaches for children with different special healthcare needs to optimize and sustain the utilization of special services.

中文翻译：

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有特殊医疗保健需求的儿童和青少年对特殊服务的利用：2016-2022 年全国儿童健康数据调查的时间事件分析


包括物理、职业、言语或行为治疗在内的特殊服务与增强有特殊医疗保健需求的儿童和青少年的长期功能和福祉相关（CYSHCN）。然而，最近缺乏关于这些服务的利用情况以及 CYSHCN 首次接受这些服务的年龄的证据。本研究评估了不同类型特殊医疗保健需求中特殊服务利用的分布、时间安排和决定因素。使用 Rao-Scott 卡方、Log-rank 和 Cox 比例风险检验对 2016-2022 年全国儿童健康调查中 63,734 名 CYSHCN 0-17 岁护理人员的数据进行了分析。总体而言，41.9%的CYSHCN曾接受过特殊服务，其中唐氏综合症、脑瘫、自闭症和其他特殊医疗需求（OSHCN）儿童和青少年的比例分别为91.4%、90.3%、88.0%和34.1%。患有唐氏综合症和脑瘫的儿童比患有自闭症或 OSHCN 的儿童更早接受特殊服务。男性儿童和青少年（aHR 1.41；95% CI：1.33–1.49）、0–5 岁（aHR：4.70；95% CI：4.32–5.11）、第二个或较晚出生的孩子（aHR：4.32–5.11）对特殊服务的利用率较高：1.18；95% CI：1.10–1.26），来自低收入家庭（aHR：1.14；95% CI：1.04–1.24），与已婚父母同住（aHR：1.11；95 % CI：1.04–1.19），与同行相比，他们始终投保（aHR：1.24；95% CI：1.08-1.42），并且健康状况更复杂（aHR：3.40；95% CI：3.13-3.70）。这些发现凸显了针对具有不同特殊医疗保健需求的儿童采取量身定制的方法的必要性，以优化和维持特殊服务的利用。