Impairment Types and Combinations Among Adolescents and Young Adults with Disabilities: Colorado 2014-2018.

Autor: Chien AT; Division of General Pediatrics (AT Chien and SL Toomey), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (AT Chien and SL Toomey), Harvard Medical School, Boston, Mass. Electronic address: alyna.chien@childrens.harvard.edu., Spence SJ; Department of Neurology (SJ Spence), Boston Children's Hospital, Boston, Mass., Okumura MJ; Division of General Pediatrics (MJ Okumura), University of California San Francisco Benioff Children's Hospital., Lu S; College of Medicine, State University of New York-Downstate (S Lu), Brooklyn, NY., Chan CH; Biostatistics and Research Design Center (CH Chan), Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass., Houtrow AJ; Department of Physical Medicine and Rehabilitation (AJ Houtrow), University of Pittsburgh School of Medicine, Pittsburgh, Pa., Kuo DZ; Department of Pediatrics (DZ Kuo), University of Rochester School of Medicine and Dentistry, Rochester, NY., Van Cleave JM; Department of Pediatrics (JM Van Cleave), Anschutz School of Medicine, University of Colorado, Aurora, CO., Shanske SA; Department of Social Work (SA Shanske), Boston Children's Hospital, Boston, Mass., Schuster MA; Kaiser Permanent Bernard J. Tyson School of Medicine (MA Schuster), Pasadena, Calif., Kuhlthau KA; Center for Child and Adolescent Health Research and Policy (KA Kuhlthau), Department of General Pediatrics, Massachusetts General Hospital for Children, Boston, Mass., Toomey SL; Division of General Pediatrics (AT Chien and SL Toomey), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (AT Chien and SL Toomey), Harvard Medical School, Boston, Mass.
Jazyk: angličtina
Zdroj: Academic pediatrics [Acad Pediatr] 2024 May-Jun; Vol. 24 (4), pp. 587-595. Date of Electronic Publication: 2023 Nov 02.
DOI: 10.1016/j.acap.2023.10.010
Abstrakt: Objective: Understanding the types of functional challenges faced by adolescents and young adults with disabilities (AYA-WD) can help payers, clinicians, community-based service providers, and policymakers recognize and meet needs. This paper describes state-level prevalence rates for 1) AYA-WD overall and for 2) impairment types singly and in combinations; and 3) examines how rates may differ between those insured by Medicaid versus commercial insurance.
Methods: This descriptive study uses Colorado's All Payer Claims Dataset 2014-2018 to identify insured 10- to 26-year-olds (Medicaid only: 333,931; commercially only: 392,444). It then applies the previously validated Children with Disabilities Algorithm (CWDA) and its companion, the Diagnosis-to-Impairment-Type Algorithm (DITA), to compare state-level prevalence rates by insurance source for disability overall and for each of five impairment types singly and in combination.
Results: Disability prevalence was greater among the Medicaid-insured AYA-WD by +7.6% points (pp)-Medicaid: 11.9% (47,654/333,931), commercial: 4.3% (16,907/392,444). Most AYA-WD had a single impairment, but the prevalence of AYA-WD with two or more impairments was greater among the Medicaid-insured than the commercially insured (+9.9 pp; Medicaid: 33.5% [15,963/47,654], commercial: 23.7% [3992/16, 907]), as was the prevalence of impairment types that were physical (+6.7 pp; Medicaid: 54.7% [26,054/47,654], commercial: 48.0% [8121/16,907]); developmental (+4.1 pp; Medicaid: 35.4% [16,874/47,654], commercial: 31.3% [5290/16,907]); psychiatric (+6.7 pp; Medicaid 21.3% [10,175/47,654], commercial: 14.6% [2470/16,907]), and intellectual (+9.3 pp; Medicaid: 26.2% [12,501/47,654], commercial: 16.9% [2858/16,907]).
Conclusions: CWDA and DITA can be used to understand the rates at which impairment types and combinations occur in a population with childhood-onset disabilities.
Competing Interests: Declaration of Competing Interest The authors have indicated that they have no conflicts of interest to disclose.
(Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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