Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic
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Introduction Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020. Method Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analysis. Results The final sample included 17,065 CYSHCN. In the fully adjusted analysis, there was a significant decrease in odds of accessing preventive dental care (adjusted odds ratio [AOR], 0.63; 95%confidence interval [CI], 0.51-0.77) and increased odds of unmet mental health care needs (AOR,1.34; 95% CI, 1.02-1.77). The inability to obtain an appointment was a barrier that increased during the study period (AOR, 2.77; 95% CI, 1.71-4.46). Discussion Novel pandemic related policies may have mitigated negative impacts on health care access for CYSHCN.
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The COVID-19 pandemic resulted in increased unmet mental health need for some children and increased barriers to accessing mental health care.
“resulting in increased unmet mental health need for some children (Gigli & Graaf, 2022) and increased barriers to accessing mental health care (, Graaf, et al., Under review).”
From Adequate Care Coordination is Associated with Reduced Unmet Mental Health Needs for Children (2026) · cites this paper as Gigli & Graaf, 2022
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Adequate Care Coordination is Associated with Reduced Unmet Mental Health Needs for Children
Graaf, G., Gigli, K., Hughes, P., & Thomas, K. C. (2026) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-026-01101-w
Self-citation
- Authors
- Gigli, K. H., & Graaf, G.
- Affiliations
- The University of Texas at Arlington (US)
- Corresponding author
- Gigli, Kristin Hittle
- Venue
- Journal of Pediatric Health Care
- Publisher
- Elsevier BV
- Published
- 2023-03
- Volume
- 37
- Issue
- 2
- Pages
- 185-192
- ISSN
- 0891-5245 (ISSN-L)
- PMC
- PMC9489986
- OpenAlex
- W4296664256
- Cited by
- 19
- References
- 0
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 5 · 2023: 2 · 2022: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Pediatric Health Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K01MH129991)
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- children and youth with special health care needs, COVID-19 pandemic, health care access, health care utilization, unmet health needs, preventive dentistry, mental health needs, barriers to care, appointment access, pandemic mitigation policy
- MeSH terms
- COVID-19, Adolescent, Child, Child Health Services, Health Services Accessibility, Health Services Needs and Demand, Humans, Children with Disabilities, Disabled Children, Pandemics
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