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Minority children are half as likely as white children to receive specialized therapies

A new study finds that 3.8 percent of children who are 18 or younger obtain specialized therapies from the health care system. These include physical, occupational, and speech therapy or home health services. When therapies provided through the special education system are included in the total, the percentage rises to just 4.3, indicating that the educational system is not a large a provider of therapies.

Researcher Karen Kuhlthau, Ph.D., of Massachusetts General Hospital and Harvard Medical School, and her colleagues used Medical Expenditure Panel Survey (MEPS) data to examine therapy use for children and its indicators. The Agency for Healthcare Research and Quality sponsors MEPS, which collects national medical care use and expenditure data at the person and household levels. Functional limitations, chronic conditions, injuries, or hospitalizations that lasted one or more days serve as predictors for which children received therapies.

Children most likely to use specialized therapies tend to be male (59.7 percent), white (80.6 percent), and have chronic conditions (38.8 percent). Black, Hispanic, and children from other non-Hispanic race/ethnic groups were much less likely to receive therapies than white children. These results suggest that either minority children are underusing therapies or white children are overusing them, according to the researchers.

The average cost per child who used therapy was $266 for physical or occupational therapy and $1,333 for home health services. Costs for the top 10 percent of therapy users averaged $997 for physical or occupational therapy and $7,279 for home health services. Therapy and home health service use comprised nearly half (46 percent) of overall health expenditures for children in the top user category.

The authors suggest that their study will assist policymakers and insurers by providing evidence about the determinants of specialized therapy use in different settings. This study was funded in part by the Agency for Healthcare Research and Quality (HS13757).

See "Correlates of therapy use and expenditures in children in the United States," by Dr. Kuhlthau, Kristen Hill, M.P.H., Christina Fluet, M.P.H., and others in the April-June 2008 Developmental Neurorehabilitation 11(2), pp. 115-123.

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