Abstract
Background
Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with disabilities, one might expect that medical care usage is elevated and will continue to be a need when children return home or age out of the system. The purpose of this study was to evaluate if medical service utilization differed between youth with and without school-identified disabilities in care, and whether certain correlates (e.g., demographic characteristics and mental health functioning) would be associated with medical service use among youth with disabilities.
Method
Hierarchical multiple regression models were used to explore the role of disability status in the utilization of medical services as well as to predict the effects of mental health functioning on utilization while controlling for other known factors.
Results
Results indicated that medical service usage for youth with school identified disabilities was statistically higher than usage for peers without disabilities after accounting for other factors associated with utilization, and internalizing and externalizing behavior severity were significantly related to medical service utilization for youth with disabilities.
Conclusions
As expected, the findings suggest that youth with disabilities use more medical services than peers without disabilities regardless of the presence of a physical health condition, but might be due to differences in the severity of the physical health conditions.
Similar content being viewed by others
Notes
Calculated from the unstandardized regression coefficient and standard deviation of the dependent variable.
References
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Asarnow, J. R., Aoki, W., & Elson, S. (1996). Children in residential treatment: A follow-up study. Journal of Clinical Child Psychology, 25, 209–214.
Bernal, P., Estroff, D. B., Aboudarham, J. F., Murphy, M., Keller, A., & Jellinek, M. S. (2000). Psychosocial morbidity: the economic burden in a pediatric health maintenance organization sample. Archives of Pediatrics and Adolescent Medicine, 154, 261–266.
Blackorby, J., Wagner, M., Cadwallader, T., Cameto, R., Levine, P., & Marder, C., (with Giacalone, P.). (2002). Behind the label: The functional implications of disability. Menlo Park, CA: SRI International. http://www.seels.net/designdocs/SEELS_FunctionalSkills.PDF.
Burns, B. J., Hoagwood, K., & Mrazek, P. J. (1999). Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2, 199–254.
Busch, M. (2003). Outcome measures in residential group care: A state association model project: Part I. Residential Group Care Quarterly, 4, 1–3.
Child Welfare League of America (CWLA). (2005). State child welfare agency survey. Washington, DC: Child Welfare League of America.
Child Welfare League of America (CWLA). (2006). Fact sheet: Behavioral management and children in residential care. Retrieved from http://www.cwla.org/advocacy/secrestfactsheet.htm.
Chmelka, M. B., Trout, A. L., Mason, W. A., & Wright, T. (2011). Children with and without disabilities in residential care: Risk at program entry, departure, and 6-month follow-up. Emotional and Behavioral Difficulties, 16(4), 383–399.
Courtney, M. E., & Dworsky, A. (2006). Early outcomes for young adults transitioning from out-of-home care in the USA. Child and Family Social Work, 11, 209–219.
Dunkle, M. C., & Nash, M. A. (1991). Beyond the health room. Washington, DC: Council of School Officers, Resource Center on Educational Equity.
Farmer, E. M., Mustillo, S. A., Wagner, H. R., Burns, B. J., Kolko, D. J., Barth, R. P., et al. (2010). Service use with multi-sector use for mental health problems by youth in contact with child welfare. Children and Youth Services Review, 32, 815–821.
Huscroft-D’Angelo, J., Trout, A. L., Epstein, M. H., & Thompson, R. (2014). The health literacy status of youth with disabilities in a residential treatment setting. Social Welfare Interdisciplinary Approach, 4(1), 109–114.
Jones, R., Everson-Hock, E. S., Guillaume, L., Goyder, E., Chilcott, J., Cooke, J., et al. (2011). Factors associated with outcomes for looked-after children and young people: A correlates review of the literature. Child: Care, Health, and Development, 37, 613–622.
Kinne, S. K., Patrick, D. L., & Doyle, D. L. (2004). Prevalence of secondary conditions among people with disabilities. American Journal Public Health, 94, 443–445.
Larzelere, R. E., Dinges, K., Schmidt, M. D., Spellman, D. F., Criste, T. R., & Connell, P. (2001). Outcomes of residential treatment: A study of adolescent clients of girls and boys town. Child and Youth Care Forum, 30, 175–185.
Lee, B. R. (2008). Defining residential treatment. Journal of Child and Family Studies, 17(5), 689–692.
Manning, W. G., & Wells, K. B. (1992). The effects of psychological distress and psychological well-being on use of medical services. Medical Care, 30, 541–553.
Nelson, T. D., Smith, T. R., Duppong Hurley, K., Epstein, M. H., Thompson, R. W., & Tonniges, T. F. (2013a). Association between psychopathology and physical health problems among youth in residential treatment. Journal of Emotional and Behavioral Disorders, 21, 150–161.
Nelson, T. D., Smith, T. R., Pick, R., Epstein, M. H., Thompson, R. W., & Tonniges, T. F. (2013b). Psychopathology as a predictor of medical service utilization for youth residential treatment. Journal of Behavioral Health Services and Research, 40, 36–45.
Smith, C. O., Thompson, M. P., Johnson, K., Nitsche, A. M., & Kaslow, N. J. (2009). Service utilization patterns of maltreated and nonmaltreated children from low-income, African American families. Psychiatric Services, 60, 1386–1389.
Trout, A. L., Casey, K., Chmelka, B., DeSalvo, C., Reid, R., & Epstein, M. H. (2009). Overlooked: Children with disabilities in residential care. Child Welfare, 88, 111–136.
Trout, A. L., Hagaman, J., Chmelka, B., Gerringher, B., Epstein, M., & Reid, R. (2008). The academic, behavioral, and mental health status of children and youth at entry to residential care. Residential Treatment for Children and Youth, 25, 359–374.
Trout, A. L., Lambert, M. C., Nelson, T. D., Epstein, M. H., & Thompson, R. (2014a). Prevalence of weight problems among youth with high-incidence disabilities in residential care. Behavioral Disorders, 39, 165–174.
Trout, A. L., Lambert, M. C., Nelson, T. D., Epstein, M. H., & Thompson, R. W. (2014b). Prevalence of physical health issues of youth with school identified disabilities in residential settings: A brief report. Disability and Health Journal. doi:10.1016/j.dhjo.2014.06.006.
U.S. Department of Health and Human Services. (2005). The surgeon general’s call to action to improve the health and wellness of persons with disabilities. Rockville, MD: Author.
Wagner, M., Marder, C., Levine, P., Camaeto, R., Cadwallader, T., Blackorby, J., et al. (2003). The individual and household characteristics of youth with disabilities: A report from the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA: SRI International.
Woods, S. B., Farineau, H. M., & McWey, L. M. (2011). Physical health, mental health, and behavior problems among early adolescents in foster care. Child: Care, Health, and Development, 39, 220–227.
World Health Organization. (2006). International statistical classification of diseases and related health problems, Tenth Revision (ICD-10) [online application]. http://apps.who.int/classifications/apps/icd/icd10online/
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lambert, M.C., Trout, A.L., Nelson, T.D. et al. Medical Service Utilization Among Youth with School-Identified Disabilities in Residential Care. Child Youth Care Forum 45, 315–327 (2016). https://doi.org/10.1007/s10566-015-9327-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10566-015-9327-9