Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Health Services Use and Health Care Expenditures for Children With Disabilities

Paul W. Newacheck, Moira Inkelas and Sue E. Kim
Pediatrics July 2004, 114 (1) 79-85; DOI: https://doi.org/10.1542/peds.114.1.79
Paul W. Newacheck
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Moira Inkelas
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sue E. Kim
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

Objective. To examine health care utilization and expenditure patterns for children with disabilities.

Methods. Secondary data analysis was conducted of the 1999 and 2000 editions of the Medical Expenditure Panel Survey (MEPS), a nationally representative survey conducted in 5 rounds by household interview. Two years of MEPS data were combined in this analysis to improve the precision of estimates. Disability was defined by the presence of a limitation in age-appropriate social role activities, such as school or play, or receipt of specialized services through the early intervention or special education programs. The survey sample included 13 792 children younger than 18 years. The overall response rate was 65.5%.

Results. Our findings demonstrate that the 7.3% of US children with disabilities used many more services than their counterparts without disabilities in 1999–2000. The largest differences in utilization were for hospital days (464 vs 55 days per 1000), nonphysician professional visits (3.0 vs 0.6), and home health provider days (3.8 vs 0.04). As a result of their greater use, children with disabilities also had much higher health care expenditures ($2669 vs $676) and higher out-of-pocket expenditures ($297 vs $189). We also found that the distributions of total and out-of-pocket expenses were highly skewed, with a small fraction of the disabled population accounting for a large proportion of expenditures: the upper decile accounted for 65% of total health care expenses and 85% of all out-of-pocket expenses for the population with disabilities. Health insurance was found to convey significant protection against financially burdensome expenses. However, even after controlling for insurance status, low-income families experienced greater financial burdens than higher income families.

Conclusions. The skewed distribution of out-of-pocket expenses found in this and earlier studies indicates that the financial burden of childhood disability continues to be shared unevenly by families. Low-income families are especially vulnerable to burdensome out-of-pocket expenses. Additional efforts are needed to protect these high-risk families.

  • disability
  • chronic conditions
  • health care expenditures
  • insurance
  • access to care
  • Received December 20, 2002.
  • Accepted January 26, 2004.
  • Copyright © 2004 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 114, Issue 1
1 Jul 2004
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Health Services Use and Health Care Expenditures for Children With Disabilities
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Health Services Use and Health Care Expenditures for Children With Disabilities
Paul W. Newacheck, Moira Inkelas, Sue E. Kim
Pediatrics Jul 2004, 114 (1) 79-85; DOI: 10.1542/peds.114.1.79

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Health Services Use and Health Care Expenditures for Children With Disabilities
Paul W. Newacheck, Moira Inkelas, Sue E. Kim
Pediatrics Jul 2004, 114 (1) 79-85; DOI: 10.1542/peds.114.1.79
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • Acknowledgments
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Insurance Mandates and Out-of-Pocket Spending for Children With Autism Spectrum Disorder
  • The cost of mental and physical health disability in childhood and adolescence to families in the UK: findings from a repeated cross-sectional survey using propensity score matching
  • Provider Perspectives of High-Quality Pediatric Hospital-to-Home Transitions for Children and Youth With Chronic Disease
  • Pediatric Chronic Critical Illness: Reducing Excess Hospitalizations
  • Hospital Utilization Among Children With the Highest Annual Inpatient Cost
  • Development of the Children With Disabilities Algorithm
  • Patient- and Family-Centered Care of Children in the Emergency Department
  • Out-of-Home Placement for Children and Adolescents With Disabilities
  • Economic Burden of Childhood Autism Spectrum Disorders
  • Medical Home and Out-of-Pocket Medical Costs for Children With Special Health Care Needs
  • Parent-Provider-Community Partnerships: Optimizing Outcomes for Children With Disabilities
  • Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States
  • Recent Trends in State Children's Health Insurance Program Eligibility and Coverage for CSHCN
  • Financial Burden of Raising CSHCN: Association With State Policy Choices
  • What Factors Are Associated With State Performance on Provision of Transition Services to CSHCN?
  • The Future of Health Insurance for Children With Special Health Care Needs
  • Financial Burden in Families of Children With Special Health Care Needs: Variability Among States
  • Association of Functional Limitation With Health Care Needs and Experiences of Children With Special Health Care Needs
  • Association of Childhood Autism Spectrum Disorders and Loss of Family Income
  • Quality Medical Homes: Meeting Children's Needs for Therapeutic and Supportive Services
  • Childhood Disability in Low- and Middle-Income Countries: Overview of Screening, Prevention, Services, Legislation, and Epidemiology
  • Role of Insurance for Children With Special Health Care Needs: A Synthesis of the Evidence
  • A Comparison of Health Care Utilization and Costs of Children With and Without Autism Spectrum Disorders in a Large Group-Model Health Plan
  • Satisfaction With Care and Ease of Using Health Care Services Among Parents of Children With Special Health Care Needs: The Roles of Race/Ethnicity, Insurance, Language, and Adequacy of Family-Centered Care
  • Pediatric Hospitalists: Report of a Leadership Conference
  • Utilization and Costs for Children Who Have Special Health Care Needs and Are Enrolled in a Hospital-Based Comprehensive Primary Care Clinic
  • Transition Planning for Youth With Special Health Care Needs: Results From the National Survey of Children With Special Health Care Needs
  • Google Scholar

More in this TOC Section

  • Neonatal SARS-CoV-2 Infections in Breastfeeding Mothers
  • Racial and Ethnic Diversity in Studies Funded Under the Best Pharmaceuticals for Children Act
  • Clinical Impact of a Diagnostic Gastrointestinal Panel in Children
Show more Articles

Similar Articles

Subjects

  • Children With Special Health Care Needs
    • Children With Special Health Care Needs
  • Administration/Practice Management
    • Standard of Care
    • Administration/Practice Management
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics