Volume 51 | Number 4 | August 2016

Abstract List

Ryan J. Coller M.D., M.P.H., Carlos F. Lerner M.D., M.Phil., Jens C. Eickhoff Ph.D., Thomas S. Klitzner M.D., Ph.D., Daniel J. Sklansky M.D., Mary Ehlenbach M.D., Paul J. Chung M.D., M.S.


To identify subgroups of U.S. children with special health care needs () and characterize key outcomes.

Data Source

Secondary analysis of 2009–2010 National Survey of CSHCN.

Study Design

Latent class analysis grouped individuals into substantively meaningful classes empirically derived from measures of pediatric medical complexity. Outcomes were compared among latent classes with weighted logistic or negative binomial regression.

Principal Findings

identified four unique subgroups: broad functional impairment (physical, cognitive, and mental health) with extensive health care (Class 1), broad functional impairment alone (Class 2), predominant physical impairment requiring family‐delivered care (Class 3), and physical impairment alone (Class 4). from Class 1 had the highest visit rates ( 3.3,  < .001) and hospitalization odds (: 12.0,  < .001) and lowest odds of a medical home (: 0.17,  < .001). in Class 3, despite experiencing more shared decision making and medical home attributes, had more visits and missed school than in Class 2 ( < .001); the latter, however, experienced more cost‐related difficulties, care delays, and parents having to stop work ( < .001).


Recognizing distinct impacts of cognitive and mental health impairments and health care delivery needs on outcomes may better direct future intervention efforts.