Add wos sample results library

02-data/intermediate/wos_sample/d56ac1bf35c0556dfd47ee795d649186-kuhlthau-k-and-nyma/info.yaml

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+abstract: 'Objective. This study examines patterns of specialist use among children
+
+  and adolescents by presence of a chronic condition or disability,
+
+  insurance, and sociodemographic characteristics.
+
+  Design. Cross-sectional analysis of national survey data, describing
+
+  rates of specialist use, with logistic regressions to examine
+
+  associations with having a chronic condition or disability, insurance
+
+  status, and sociodemographic variables.
+
+  Setting. The 1999 National Health Interview Survey, a nationally
+
+  representative household survey.
+
+  Participants. Children and adolescents 2 to 17 years old.
+
+  Outcome. Parental/respondent reports of specialist visits based on
+
+  reports of the child having seen or talked to a medical doctor who
+
+  specializes in a particular medical disease or problem about the child''s
+
+  health during the last 12 months.
+
+  Results. Thirteen percent of US children were reported as seeing a
+
+  specialist in the past year. Specialist-visit rates were twice as high
+
+  for children with a chronic condition or disability (26\% vs 10.2\%).
+
+  The specialist utilization rates for children without insurance were
+
+  much lower than those for insured children, but among the children who
+
+  have coverage (private, Medicaid, or other), specialist-utilization
+
+  rates were similar (no statistically significant difference).
+
+  Results of multivariate analyses predicting the use of specialists
+
+  confirm the above-mentioned findings. Additionally, they show that use
+
+  of specialist care was lower among children in the middle age group,
+
+  minorities, children in families between 100\% and 200\% of the federal
+
+  poverty level, and lower parental educational levels. We found no
+
+  difference in specialist-visit rates between rural- and urban-dwelling
+
+  children, by family status, or by gender. Differences in specialist use
+
+  by gatekeeping status are found only among subgroups.
+
+  Conclusions. The results showed that, overall, 13\% of children used a
+
+  specialist in a year. Among the insured, a slightly greater percentage
+
+  of children used such care (15\%). These numbers were slightly lower
+
+  than the 18\% to 28\% of pediatric patients referred per year in 5 US
+
+  health plans, although the sources of data and definitions of specialist
+
+  use differ. Our results showed that 26\% of children with a chronic
+
+  condition or disability who were insured by Medicaid use a specialist.
+
+  Although the data are not directly comparable, this is within the range
+
+  of previous findings showing annual rates by condition of use between
+
+  24\% and 59\%. These findings are consistent also with greater use of
+
+  many different types of health care by children with special health care
+
+  needs.
+
+  Medicaid-utilization rates presented here were similar also to the rates
+
+  found among privately insured children and children with ``other{''''}
+
+  insurance. In our earlier work examining use of specialists by children
+
+  insured by Medicaid, we speculated that Medicaid-insured children might
+
+  face particular difficulty with access (eg, due to transportation or
+
+  language barriers). The findings presented here suggest that children
+
+  insured by Medicaid had no different use of specialists than other
+
+  insured children. We do not know, however, whether similar rates are
+
+  appropriate.
+
+  As predicted, sociodemographic differences were pronounced and followed
+
+  patterns typically found for use of health services. Lower rates of
+
+  specialist use by non-Hispanic blacks and Hispanics remains even,
+
+  controlling for chronic condition/disability, status, insurance, and
+
+  socioeconomic status. This is an important issue that not only needs to
+
+  be addressed in using specialist care but also in many areas in health
+
+  care. It is the near poor who seem to have difficulty accessing care (as
+
+  is evidenced by lower use of specialists). In a study of access to care,
+
+  similar results were found, with those between 125\% and 200\% of the
+
+  federal poverty level being less likely to have a usual source of care.
+
+  This is roughly the population targeted by the State Children''s Health
+
+  Insurance Programs.
+
+  These findings cannot determine whether rates of use are too high or too
+
+  low. Additional work on outcomes for children who do and do not use
+
+  specialist care would further inform the work presented here. Extending
+
+  that work to examine patterns of care including but not limited to
+
+  specialists and generalists would be even better.'
+affiliation: 'Kuhlthau, K (Corresponding Author), Harvard Univ, Sch Med, MassGen Hosp
+  Children, Dept Pediat,Ctr Child \& Adolescent Hlth Policy, 50 Staniford St,Ste 901,
+  Boston, MA 02114 USA.
+
+  Harvard Univ, Sch Med, MassGen Hosp Children, Dept Pediat,Ctr Child \& Adolescent
+  Hlth Policy, Boston, MA 02114 USA.
+
+  Harvard Univ, Sch Med, Massachusetts Gen Hosp, Inst Hlth Policy,Dept Med,Div Gen
+  Med, Boston, MA USA.
+
+  Commonwealth Fund, Qual Care Underserved Populat, New York, NY USA.'
+author: Kuhlthau, K and Nyman, RM and Ferris, TG and Beal, AC and Perrin, JM
+author-email: kkuhlthau@partners.org
+author_list:
+- family: Kuhlthau
+  given: K
+- family: Nyman
+  given: RM
+- family: Ferris
+  given: TG
+- family: Beal
+  given: AC
+- family: Perrin
+  given: JM
+da: '2023-09-28'
+doi: 10.1542/peds.113.3.e249
+eissn: 1098-4275
+files: []
+issn: 0031-4005
+journal: PEDIATRICS
+keywords: 'Medicaid; specialist; insurance; pediatric; child; disability; chronic
+
+  condition'
+keywords-plus: 'HEALTH-CARE; ETHNIC-DIFFERENCES; ENROLLED CHILDREN; CHRONIC ILLNESS;
+
+  MEDICAID; ADOLESCENTS; ACCESS; GENERALISTS; PREVALENCE; INCOME'
+language: English
+month: MAR 1
+number: '3'
+number-of-cited-references: '32'
+orcid-numbers: Perrin, James/0000-0002-1810-3708
+pages: E249-E255
+papis_id: 018d1ffd725fa57f8c9bf6287163152e
+ref: Kuhlthau2004correlatesuse
+times-cited: '62'
+title: Correlates of use of specialty care
+type: Article
+unique-id: WOS:000189344400059
+usage-count-last-180-days: '0'
+usage-count-since-2013: '6'
+volume: '113'
+web-of-science-categories: Pediatrics
+year: '2004'