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High healthcare costs for children with special healthcare needs

According to an article published in Archives of Pediatrics & Adolescent Medicine (159, 10–17 [2005]), children with special healthcare needs (CSHCN) comprise of less than 16% of the child population, but have healthcare expenditures which are three-times higher than other children. CSHCN are defined as those children who have or are at an 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 with other children, CSHCN use more healthcare services and thus have higher healthcare costs. Paul W Newacheck (University of California, CA, USA) and colleagues used data from the 2000 Medical Expenditure Panel Survey in order to examine the healthcare expenditures of CSHCN. A total of 6965 children under the age of 18 years were included in the survey, with 949 (15.6%) identified as CSHCN. From these data the number of CSHCN in the USA was estimated at 11 million. In 2000, CSHCN had an average healthcare expenditure of US$2099, compared with children without special healthcare needs who had an average expenditure of US$628. CSHCN accounted for 42.1% of total medical care costs (excluding dental costs) and 33.6% of total healthcare costs (including dental costs) for children. These children also had more than twice as many physician visits and seven-times as many nonphysician visits than other children, and had average out-of-pocket costs (for all healthcare) twice that of other children (US$352 vs. 174). Average annual expenditures on prescribed medications were ten-times higher (US$340 vs. 34) for CSHCN. “Our results show that CSHCN use many more services and have significantly higher healthcare 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,” Paul Newacheck concludes.