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Children with special health care needs in Switzerland: prevalence, health care utilization and social determinants

English title Children with special health care needs in Switzerland: prevalence, health care utilization and social determinants
Applicant Mohler-Kuo Meichun
Number 125486
Funding scheme Project funding (Div. I-III)
Research institution Institut für Epidemiologie, Biostatistik und Prävention Universität Zürich
Institution of higher education University of Zurich - ZH
Main discipline Public Health and Health Services
Start/End 01.06.2009 - 31.10.2012
Approved amount 375'000.00
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All Disciplines (3)

Discipline
Public Health and Health Services
Methods of Epidemiology and Preventive Medicine
Social Paediatrics

Keywords (3)

children with special health care needs; health care utilization; social determinants

Lay Summary (English)

Lead
Lay summary
Lead: Chronic health conditions among children have significant impacts on children and their families. This study will estimate the prevalence of children with special health care needs (CSHCN) among 10-14 years old in Switzerland and to evaluate their use of health care service.Background: Children with chronic conditions who survive beyond the age of 10 have increased dramatically over the past few decades due to the medical advances. It is estimated that children with chronic health condition account for more than half of the children-related health care cost. Caring for a child with special health care need has a great impact on the family. However, it is difficult to estimate the prevalence of chronic health conditions among children. There is no unanimity on the definition of 'chronic health condition'. which could include a broad range of physical, developmental, behavioral, and emotional conditions. There is also a lack of quality data specifically on this age group. Most health surveys target respondents 15 years or older. Surveys focusing on children have generally used school-based samples. However, children with a chronic health condition may not attend regular schools and the estimation therefore tends to be conservative. Objectives: The aims of the study is to estimate the prevalence and to describe the characteristics of CSHCN in Switzerland and to evaluate quality of life and access to health care services; in particular, to identify the barriers in access to health care and to evaluate the extent of social inequality in health care among these children. Methods: The study plans to recruit about 1200-1500 CSHCN ages 10-14 years old in Switzerland. A random sample of 20,000 children from 200 communities in all Switzerland will be obtained. Computer-assisted telephone interview will be conducted using a recently developed 'CSHCN Screener' to screen all 20,000 children. Those families who are screened positive will be further invited to continue the second part of the survey to obtain detailed information about the family status, barriers of health care utilization, quality of life and the impact on the family. Additional 1500 children without chronic condition will be included as a comparison group.Significance: The results of the study are expected to fill informational gaps with respect to the prevalence of CSHCN in Switzerland, their quality of life, and health care service utilization. In particular, it will provide important insight into necessary health care policies and interventions for the most disadvantaged group of children and adolescents.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Health-related quality of life among children with mental health problems: a population-based approach.
Dey Michelle, Mohler-Kuo Meichun, Landolt Markus A (2012), Health-related quality of life among children with mental health problems: a population-based approach., in Health and quality of life outcomes, 10, 73-73.
Assessing parent-child agreement in health-related quality of life among three health status groups.
Dey Michelle, Landolt Markus A, Mohler-Kuo Meichun (2012), Assessing parent-child agreement in health-related quality of life among three health status groups., in Social psychiatry and psychiatric epidemiology, 1-4.
An analysis of non-response in a Swiss national survey.
Dey Michelle, Mohler-Kuo Meichun (2012), An analysis of non-response in a Swiss national survey., in International journal of public health, 1-4.
Health-related quality of life among children with mental disorders: a systematic review.
Dey Michelle, Landolt Markus A, Mohler-Kuo Meichun (2012), Health-related quality of life among children with mental disorders: a systematic review., in Quality of life research : an international journal of quality of life aspects of treatment, care an, 1-18.

Collaboration

Group / person Country
Types of collaboration
Institut für Sozial- & Präventivmedizin, Universität Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
UCL Epidemiology and Public Health, University College London Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
National Survey of Children with Special Health Care Needs in Switzerland, Interne Fortbildung,Herbstsemester 2012 07.11.2012 Zurich, Switzerland
Swiss Public Health Conference 2011 25.08.2012 Basel, Switzerland
11th Scientific Meeting of the Swiss Society of Psychiatric Epidemiology 2012, Basel, 20th June. 20.06.2012 Basel, Switzerland
20th IUHPE World Conference on Health Promotion 11.07.2010 Geneva, Switzerland


Awards

Title Year
Swiss School of Public Health, PhD. Grant 2010

Associated projects

Number Title Start Funding scheme
163379 Swiss Youth Epidemiological Study on Mental Health (S-YESMH) 01.01.2016 Project funding (Div. I-III)
173235 Mental health literacy and stigma: a Swiss survey among students in post-mandatory schools 01.06.2017 Project funding (Div. I-III)
163379 Swiss Youth Epidemiological Study on Mental Health (S-YESMH) 01.01.2016 Project funding (Div. I-III)

Abstract

Due to medical advances, the survival rates of children with chronic conditions who survive beyond the age of 10 have increased dramatically over the past few decades. It is estimated that children with chronic health condition account for more than half of the children-related health care cost . Chronic health conditions among children are stressful adversities that can have significant psychosocial and developmental impacts upon children themselves and their families as well. Caring for a child with special health care need has a great impact on the family including financial burdens, employment difficulties and time burdens in providing care. The impact on the family is especially great for disadvantaged families. Despite the impact, it has proven difficult to estimate the prevalence of chronic health conditions among children. First, there is no unanimity on the definition of ‘chronic health condition’, which could include a broad range of physical, developmental, behavioral, and emotional conditions such as asthma, depression, autism, learning disabilities etc. Second, there is a lack of quality data focusing specifically on this age group. Most health surveys target respondents 15 years or older. Third, surveys focusing on children have generally used school-based samples. However, children with a chronic health condition may not attend regular schools and the estimation therefore tends to be conservative. In spite of limited data, it is estimated that the prevalence of chronic health conditions in children and adolescents is between 10% and 30% in Western countries, depending upon the definitions used. To address current gaps in research, we proposed a community-based study that targets children with special health care needs in Switzerland using a population-based sample. The study has the following main aims: 1)To estimate the prevalence and to describe the characteristics of children with special health care needs in Switzerland using a national representative sample; 2)To evaluate quality of life and access to health care services among children with special health care needs in Switzerland and their changes over time; in particular to identify the barriers in access to health care and to evaluate the extent of social inequality in health care among these children;3)To identify multi-level indicators guided by the conceptual framework which is (community/ regional level, family, and individual levels) associated with health care service use among children with special health care needs.4) To compare the prevalence and characteristics of children with special health care needs in Switzerland with a similar national survey conducted in the U.S.The proposed study plans to recruit about 1200-1500 children ages 10-14 years old with special health care needs in Switzerland. First, a random sample of 20,000 children from 200 communities in all Switzerland will be obtained. Computer-assisted telephone interview will be conducted using a recently developed ‘Children with Special Health Care Needs (CSHCN) Screener’ to screen all 20,000 children. The CSHCN Screener has been widely used and validated in the U.S. National Survey of Children with Special Health Care Needs and has also recently been validated in a study in which seven European countries. Those families who are screened positive will be further invited to continue the second part of the survey to obtain detailed information about the family status, barriers of health care utilization, quality of life and the impact on the family. Additional 1500 children without chronic condition will be included as a comparison group.Therefore, the finding from the planned study would provide an estimate of the prevalence of children with special health care needs and a profile of this population, which not yet available to researchers. In addition, the planned study will examine to what extent social inequality exists in the disadvantaged population of this cohort. . The results of the planned study are expected to fill informational gaps that currently exist with respect to the prevalence of children with special health care needs in Switzerland, including the issues of development, quality of life, and health care service utilization. In particular, it will provide important insight into necessary health care policies and interventions for the most disadvantaged group of children and adolescents
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