Access to Health Care for Children and Youth with Special Health Care Needs in Kansas: A Retrospective Analysis

Abstract

Introduction. Despite the high prevalence of Children and Youth with Special Health Care Needs (CYSHCN) in the United States, health care services for this population remain insufficient. Prior studies have documented disparities in both access to and quality of care. We aimed to evaluate health care access and barriers among CYSHCN in Kansas.

Methods. Using data from the 2021 National Survey of Children’s Health (NSCH), we conducted a retrospective, quasi-experimental analysis of health care access and barriers among 1,696 Kansas households. Children were classified as having special health care needs based on diagnoses across 24 specified conditions.

Results. Although most CYSHCN in Kansas reported adequate access to health care (97.2%), significant barriers persist, particularly among those with lifelong conditions. These children were more likely to report needing care but not receiving it (χ² _Rao-Scott (1, n = 1696) = 11.64; p <0.001; OR 0.29; 95% CI, 0.14-0.61), primarily due to appointment or service unavailability and cost. They also were more likely to report difficulty paying medical bills (χ² _Rao-Scott (1, n = 1291) = 10.21; p <0.001; OR 0.49; 95% CI, 0.31-0.77), and a greater proportion lived in poverty (χ² _Rao-Scott (1, n = 1696) = 5.29; p = 0.021; OR 0.74; 95% CI, 0.57-0.96).

Conclusions. While CYSHCN in Kansas generally reports adequate health care access, important barriers remain. Efforts to improve access to specialty care, reduce costs, and enhance insurance coverage are essential to improving care for this vulnerable population.