%0 Journal Article
%T Assessing Systems of Care for US Children with Epilepsy/Seizure Disorder
%A Mary Kay Kenney
%A Marie Mann
%J Epilepsy Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/825824
%X Background. The proportion of US children with special health care needs (CSHCN) with epilepsy/seizure disorder who receive care in high-quality health service systems was examined. Methodology. We analyzed data for 40,242 CSHCN from the 2009-2010 National Survey of CSHCN and compared CSHCN with epilepsy/seizure disorder to CSHCN without epilepsy/seizure disorder. Measures included attainment rates for 6 federal quality indicators with comparisons conducted using chi square and logistic regression methods. In addition, CSHCN with epilepsy/seizure disorder were compared to CSHCN without epilepsy/seizure disorder on the basis of 14 unmet health care needs. Results. Lower attainment rates for receiving comprehensive care in a medical home and easily accessible community-based services were found for CSHCN with epilepsy/seizure disorder versus CSHCN without epilepsy/seizure disorder (medical home: 32% versus 43%; accessible community-based services: 50% versus 66%, resp.) in unadjusted analyses. Lower adjusted odds for these indicators as well as greater unmet need for specialists, dentistry, prescriptions, therapies, and mental health care were also found for CSHCN with epilepsy/seizure disorder. Conclusions. Further efforts are needed to improve attainment of high-quality health care services for CSHCN with epilepsy/seizure disorders. 1. Introduction Childhood seizures are often accompanied by cognitive and behavioral deficits which may be induced or exacerbated by the seizure disorder and vary based on underlying neuropathology (e.g., perinatal brain injury and congenital central nervous system malformation), seizure type, age of onset, psychosocial problems, and treatment side effects [1]. Recent research has increased our understanding of the range of difficulties accompanying a diagnosis of childhood epilepsy/seizure disorder. Children with currently reported epilepsy/seizure disorder were significantly more likely than those never diagnosed to experience depression, anxiety, attention deficit/hyperactivity disorder, conduct problems, learning disability, developmental delay, and autism/autism spectrum disorder [2]. They had greater risk of experiencing a range of physical health comorbidities including hearing or vision problems, asthma, headaches, allergies, ear infections, and poor oral health. Functionally, children with current epilepsy/seizure disorder were more likely to have limited activity, grade repetition, school problems, and low social competence compared with children never diagnosed. High levels of parent aggravation were also
%U http://www.hindawi.com/journals/ert/2013/825824/