Special needs children with medical complexity, who see multiple specialists for more than one chronic condition, are more likely to have a health care need go unmet, according to a paper by Dennis Kuo, M.D., an associate professor of pediatrics at the University of Arkansas for Medical Sciences (UAMS) and the Arkansas Children’s Research Institute (ACRI), published this month in the prestigious, peer-reviewed journal Health Affairs.
“Among the children with medical complexity, unmet need was not associated with primary language, income level, or having Medicaid,” wrote Kuo and second author Anthony Goudie, Ph.D., an assistant professor of pediatrics at UAMS. “We concluded that medical complexity itself can be a primary determinant of unmet needs.”
Kuo’s and Goudie’s research has been supported by the UAMS Translational Research Institute as a KL2 Mentored Career Development Award recipients, which provided each with two years of salary support, research funding and training.
The paper, entitled Inequities in Health Care Needs for Children with Medical Complexity, was presented Monday at the National Press Club in Washington, D.C. It appears in Health Affairs’ December issue focusing on children’s health.
Based on a secondary analysis of data from the 2005–06 and 2009–10 National Survey of Children with Special Health Care Needs, the inequities the paper examined were those based on race or ethnicity, primary language in the household, insurance type and poverty status. The paper compares inequities of children with special needs to those of children with special needs who also have medical complexity. The results indicate children with medical complexity are more than twice as likely to have at least one unmet need compared to children with special needs without medical complexity.
An abstract of the paper can be viewed online. Copies of the entire study are available to members of the media upon request.
Kuo is also a co-author of the paper Children with Medical Complexity and Medicaid: Spending and Cost Savings, which was also accepted by Health Affairs and is also being presented at the National Press Club. Its primary author is Jay Berry, M.D., an assistant professor of pediatrics at Boston Children’s Hospital.
Kuo is the second TRI KL2 graduate to be invited to speak at the National Press Club by Health Affairs. In 2011, Holly Felix, Ph.D., M.P.A., presented her findings at the Washington, D.C., venue that community health workers could achieve significant Medicaid savings by connecting the elderly and disabled adults in the Delta to community-based health services, enabling them to remain in their homes rather than moving to long-term care institutions. The NIH is funding an expansion of her earlier study, which was conducted in three counties calculated savings of $2.6 million over three years in those counties.