About Children & Youth with Special Health Care Needs CYSHCN
Children and Youth with Special Health Care Needs (CYSHCN) are "those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." [McPherson: 1998] The National Survey of Children with Special Health Care Needs 2009/2010 found 15.1% of the nation's children met this definition of children with special health care needs. Child Health Data National Survey of CSHCN The prevalence of children who meet criteria as CYSHCN, particularly if one does not include those deemed "at-risk," increases with age as chronic conditions develop and their needs for healthcare increase.
The number of CYSHCN cared for by a primary care clinician and how often they are seen will depend on a number of factors, including the local prevalence of CYSCHN, how welcome their families feel in the practice, referrals by subspecialists, the breadth of insurance plans, including Medicaid and CHIP, with which the practice contracts, etc. Since the number of children in a pediatric practice usually ranges from about 1,800 to 2,500, the number of CYSHCN cared for by a given pediatrician would be expected to range from about 250 to 400.
Myriad resources exist to guide clincians and to educate and support parents as they strive to provide the best care possible to assure optimal outcomes for their CYSHCN and their families. However, finding reliable, up-to-date information can be challenging, particularly when a lot of unreliable information is readily available. Finding helpful resources and local service providers, incuding pediatric specialty services, can be very difficult. We hope that this website will help – use the Feedback button at the bottom of the page to let us know how we can better serve your needs.
Resources
Information & Support
For Professionals
ChildHealthData.org
Provides extensive data about CSHCN for the nation and for each state; offered by the Child and Adolescent Health Measurement
Initiative (CAHMI).
National Ambulatory Medical Care Survey
A national survey designed to meet the need for objective, reliable information about the provision and use of ambulatory
medical care services in the United States. Findings are based on a sample of visits to nonfederally employed office-based
physicians who are primarily engaged in direct patient care. Physicians in the specialties of anesthesiology, pathology, and
radiology are excluded from the survey. The survey was conducted annually from 1973 to 1981, in 1985, and annually since 1989.
National Hospital Discharge Survey
A national probability survey designed to meet the need for information on characteristics of inpatients discharged from non-Federal
short-stay hospitals in the United States. The NHDS collects data from a sample of approximately 270,000 inpatient records
acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days
for all patients, general hospitals, or children's general hospitals are included in the survey. Federal, military, and Department
of Veterans Affairs hospitals, as well as hospital units of institutions (such as prison hospitals), and hospitals with fewer
than six beds staffed for patient use, are excluded.
Medical Home Training and Education (AAP)
From the American Academy of Pediatrics, this page provides resources for medical providers to improve care for patients and
includes toolkits, links to information about Medical Home, CME resources, and more.
Children & Youth with Special Health Care Needs Knowledge Path (MCH Library)
Compilation of reports, websites, data, etc. from the National Center for Education in Maternal and Child Health's MCH Library,
based at Georgetown University.
Helpful Articles
Haggerty RJ.
Caring for children with special needs: historical perspective.
Acad Pediatr.
2011;11(2):107-9.
PubMed abstract
Long WE, Bauchner H, Sege RD, Cabral HJ, Garg A.
The value of the medical home for children without special health care needs.
Pediatrics.
2012;129(1):87-98.
PubMed abstract
Romaire MA, Bell JF, Grossman DC.
Medical Home Access and Health Care Use and Expenditures Among Children With Special Health Care Needs.
Arch Pediatr Adolesc Med.
2011.
PubMed abstract
Bethell CD, Kogan MD, Strickland BB, Schor EL, Robertson J, Newacheck PW.
A national and state profile of leading health problems and health care quality for US children: key insurance disparities
and across-state variations.
Acad Pediatr.
2011;11(3 Suppl):S22-33.
PubMed abstract
Strickland BB, van Dyck PC, Kogan MD, Lauver C, Blumberg SJ, Bethell CD, Newacheck PW.
Assessing and ensuring a comprehensive system of services for children with special health care needs: a public health approach.
Am J Public Health.
2011;101(2):224-31.
PubMed abstract
Palfrey JS, Huntington NL, Yusuf A, Foley SM, Nary D, Jenkins R.
Viewing services for children and youth with special health care needs through a community lens.
Pediatrics.
2010;126 Suppl 3:S107-10.
PubMed abstract / Full Text
Kuo DZ, Bird TM, Tilford JM.
Associations of family-centered care with health care outcomes for children with special health care needs.
Matern Child Health J.
2011;15(6):794-805.
PubMed abstract
Authors & Reviewers
Author: | Medical Home Team |
2009: first version: Chuck Norlin, MDA |
Page Bibliography
Bethell CD, Kogan MD, Strickland BB, Schor EL, Robertson J, Newacheck PW.
A national and state profile of leading health problems and health care quality for US children: key insurance disparities
and across-state variations.
Acad Pediatr.
2011;11(3 Suppl):S22-33.
PubMed abstract
Haggerty RJ.
Caring for children with special needs: historical perspective.
Acad Pediatr.
2011;11(2):107-9.
PubMed abstract
Kuo DZ, Bird TM, Tilford JM.
Associations of family-centered care with health care outcomes for children with special health care needs.
Matern Child Health J.
2011;15(6):794-805.
PubMed abstract
Long WE, Bauchner H, Sege RD, Cabral HJ, Garg A.
The value of the medical home for children without special health care needs.
Pediatrics.
2012;129(1):87-98.
PubMed abstract
McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B.
A new definition of children with special health care needs.
Pediatrics.
1998;102(1 Pt 1):137-40.
PubMed abstract
Palfrey JS, Huntington NL, Yusuf A, Foley SM, Nary D, Jenkins R.
Viewing services for children and youth with special health care needs through a community lens.
Pediatrics.
2010;126 Suppl 3:S107-10.
PubMed abstract / Full Text
Romaire MA, Bell JF, Grossman DC.
Medical Home Access and Health Care Use and Expenditures Among Children With Special Health Care Needs.
Arch Pediatr Adolesc Med.
2011.
PubMed abstract
Strickland BB, van Dyck PC, Kogan MD, Lauver C, Blumberg SJ, Bethell CD, Newacheck PW.
Assessing and ensuring a comprehensive system of services for children with special health care needs: a public health approach.
Am J Public Health.
2011;101(2):224-31.
PubMed abstract