Highlights
- •This is the first epidemiological survey of the prevalence of CSHCN in Brazil.
- •One in every four families had one 0–11-year-old child with special health care needs.
- •The CSHCN prevalence was associated with the child's previous health conditions, family structure, socioeconomic, and political context.
- •The instrument facilitates identification of CSHCN in Brazil and allows international comparisons.
Abstract
Purpose
We aimed to estimate the prevalence and delineate the profile of children with special
healthcare needs (CSHCN) in the three municipalities of Brazil's southern and southeastern
regions from 2015 to 2017.
Design and methods
This cross-sectional study included 6853 children aged 0–11 years. Participants were
selected through complex sampling in 32 primary healthcare units. The Brazilian version
of the Children with Special Healthcare Needs Screener© and a questionnaire were used
to identify sociodemographic and family characteristics, health status, and health
services utilization. Simple and multiple logistic regression models were used to
evaluate the association between family and child characteristics and prevalence (P < 0.05).
Results
The prevalence of CSHCN was 25.3% (95% confidence interval: 21.0–30.0). Most participants
required health services or were on long-term medication for a current chronic condition;
approximately 53% of CSHCN had no formally recorded diagnoses. The most frequent health
problems were respiratory conditions, asthma, and allergies. Approximately 60% of
the CSHCN patients underwent follow-up examinations of the specialties pneumology,
pediatrics, otorhinolaryngology, speech therapy, neurology, and psychology. Children
of school age, of male sex, with premature birth, with a history of recurrent hospitalization,
from non-nuclear families, and from underprivileged social classes were identified
as risk factors for classification as CSHCN.
Practice implication
These results contribute to the unprecedented mapping of these children in healthcare
networks in Brazil.
Conclusion
The high prevalence of CSHCN in medium and large municipalities in the southern and
southeastern regions was associated with the child's previous health conditions and
family structure.
Keywords
Abbreviations:
ABEP (Associação Brasileira de Empresas de Pesquisa (Brazilian Association of Research Companies)), AIC (Akaike′s information criterion), PHC (Primary Healthcare), ATC (Anatomical Therapeutic Chemical), CSHCN (Children with special healthcare needs), CS© (Children with special healthcare needs Screener©), CS©- Brazilian version (Children with special healthcare needs Screener©Brazilian version), PPS (Probability Proportional to Size)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 02, 2022
Accepted:
August 18,
2022
Received in revised form:
August 11,
2022
Received:
May 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
