To examine health and insurance characteristics of adolescents with special health care needs (ASHCN), at state and federal levels.
We used the National Survey of Children's Health 2003, a nationally representative sample of children in the United States, to study adolescents 14-17 years of age. We present descriptive statistics and regression analyses of adolescents with and without special health care needs, regarding measures of health care use and insurance coverage.
Approximately 22% of adolescents 14-17 years old have a special health care need. On average, ASHCN have one more annual office visit per year than their non-SHCN peers (p < .001). ASHCN report three times the rate of unmet medical needs compared to their non-SHCN peers (p < .001), despite higher rates of insurance coverage (94% vs. 88%, p < .001). Overall, 26.9% of ASHCN have public coverage. Nationally, more than half of those ASHCN with public coverage report incomes above 100% of the federal poverty level (FPL), which puts them at risk for losing coverage when they age into adulthood. Across states, proportions of ASHCN on public coverage and with incomes > 100% FPL range from 3.2% to 37.5%.
One in six ASHCN currently has public coverage with household income that would make them ineligible by income criteria for continuing public coverage as adults. It is imperative to examine insurance continuity and corresponding health outcomes for ASHCN as they transition from child to adult health care settings, and to evaluate options for policy interventions that can sustain health care coverage for this vulnerable population.
[Show abstract][Hide abstract] ABSTRACT: OFDM-CDMA using a joint frequency-time spreading method is one of the best candidates for future broadband wireless multimedia communication systems. Different channel-interleaving methods, including bit interleaving and chip interleaving, are investigated. Computer simulations show that the interleaving methods within one OFDM symbol (i.e. only in the frequency domain) can achieve BER performance as good as those within several OFDM symbols (i.e. not only in the frequency domain, but also in the time domain) with less complexity because the joint frequency-time spreading method has already exploited the time diversity.
Communications, Circuits and Systems, 2004. ICCCAS 2004. 2004 International Conference on; 07/2004
[Show abstract][Hide abstract] ABSTRACT: Renal transplantation is the therapy of choice for children with end-stage renal disease (ESRD). Ethnicity affects the transplant survival rates substantially, but there has been no European academic evaluation of the effects of immigration on the pediatric renal transplantation outcome. The aim of this study was to compare the outcomes of renal transplantation between the children of immigrant families and the children of native families at the pediatric nephrology unit of the Medical University of Vienna, Austria. We conducted a retrospective study on all children who underwent renal transplantation at our center between January 1997 and June 2005. The patients were separated into two groups according to their immigration backgrounds. During the time frame of our study, 59 children underwent a total of 63 transplantations. Of these children, 42 were from native Austrian and 17 were from first-generation immigrant families. We analyzed the demographic data and outcome parameters for each of the 59 patients. We found no difference in patient and graft survival rates or long-term function between native and immigrant children. The two groups were also comparable in the rates of acute rejection episodes, 24-h blood pressure, and growth velocity. Living donor source had a positive influence on graft function (p=0.06), 24-h blood pressure (p=0.05), and growth velocity (p=0.02) only in the immigrant group. Our retrospective analysis shows no influence of the migration status on the patient or graft outcome, but we did find that immigrant children benefitted more than native children from living donation as opposed to deceased donation. To explain this fact, biological, heath-economical, psychosocial, and cultural background aspects must be investigated.
European Journal of Pediatrics 04/2008; 168(1):11-6. DOI:10.1007/s00431-008-0698-x · 1.89 Impact Factor
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