abstract: 'Objectives. To determine whether family resources predict use of

  therapeutic and supportive services and unmet needs in medical versus

  educational settings.

  Data Source. Children 5-17 years of age with at least one functional

  limitation (n=3,434) from the 1994 to 1995 Disability Supplement to the

  U.S. National Health Interview Survey.

  Study Design. Family resources included the child''s type of health

  insurance, household education level, and poverty status. Therapeutic

  services included audiology; social work; occupational, physical, or

  speech therapy. Supportive services included special equipment, personal

  care assistance, respite care, transportation, or environmental

  modifications. Need was controlled by child health status and the

  severity and type of functional limitation(s). Age, gender,

  race/ethnicity, family size, and structure were covariates.

  Data Analysis Methods. Logistic regression provided estimates of

  associations between-family resources and use of or unmet need for

  therapeutic and supportive services. Multinomial methods were used to

  determine therapeutic service outcomes in medical versus educational

  settings.

  Principal Findings. Children with public insurance were two to three

  times more likely to use services than children with private or no

  insurance regardless of type of service. Household education and public

  insurance were associated with supportive and therapeutic service use,

  but for therapeutic services only among children receiving services

  beyond the school setting. Household education predicted unmet need for

  both types of services and therapeutic services across settings.

  Findings should be interpreted cautiously, given the survey''s dependence

  on respondent report to define the need for services and the potential

  for overrepresentation of children with more severe needs in the public

  insurance category.

  Conclsions. Disparities in the use of services by household education

  level and by type of health insurance across service settings suggests

  inequitable access among the U.S. policies and programs serving children

  with functional limitations. Family income and education appear to give

  families an advantage in obtaining services and in identifying a child''s

  unmet need.'
affiliation: 'Benedict, RE (Corresponding Author), Univ Wisconsin, Dept Kinesiol,
  Waisman Ctr Study Human Dev Dev Disabil, Program Occupat Therapy,Sch Educ, 123 Waisman
  Ctr,1500 Highland Ave, Madison, WI 53705 USA.

  Univ Wisconsin, Dept Kinesiol, Waisman Ctr Study Human Dev Dev Disabil, Program
  Occupat Therapy,Sch Educ, Madison, WI 53705 USA.'
author: Benedict, RE
author_list:
- family: Benedict
  given: RE
da: '2023-09-28'
doi: 10.1111/j.1475-6773.2005.00468.x
files: []
issn: 0017-9124
journal: HEALTH SERVICES RESEARCH
keywords: 'child; disability; therapeutic and supportive services; education versus

  medical setting'
keywords-plus: 'HEALTH-CARE NEEDS; MEDICAID MANAGED CARE; CHRONIC ILLNESSES;

  NATIONAL-SURVEY; ACCESS; INSURANCE; DISABILITIES; ADOLESCENTS; PROGRAM;

  IMPACT'
language: English
month: FEB
number: '1'
number-of-cited-references: '41'
pages: 103-124
papis_id: e2e748be24afaaa00784efbf7fcbf400
ref: Benedict2006disparitiesuse
times-cited: '40'
title: 'Disparities in use of and unmet need for therapeutic and supportive services
  among school-age children with functional limitations: A comparison across settings'
type: article
unique-id: WOS:000234668200007
usage-count-last-180-days: '0'
usage-count-since-2013: '12'
volume: '41'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2006'