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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 8/2014

01-10-2014

Understanding Utilization of Outpatient Clinics for Children with Special Health Care Needs in Southern Israel

Authors: Hagit Peres, Yael Glazer, Daniella Landau, Kyla Marks, Hana’a Abokaf, Ilana Belmaker, Arnon Cohen, Ilana Shoham-Vardi

Published in: Maternal and Child Health Journal | Issue 8/2014

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Abstract

To understand the pattern of utilization of ambulatory care by parents of children with special health care needs (CSHCN) and to explore parental challenges in coping with health maintenance of their infants after discharge from a neonatal intensive care unit (NICU). CSHCN require frequent utilization of outpatient ambulatory clinics especially in their first years of life. Multiple barriers are faced by families in disadvantaged populations which might affect adherence to medical referrals. Our study attempts to go beyond quantitative assessment of adherence rates, and capture the influence of parental agency as a critical factor ensuring optimal utilization of healthcare for CSHCN. A prospective, mixed-methods, cohort study followed 158 Jewish and Bedouin-Arab infants in the first year post discharge from NICU in southern Israel. Rates of utilization of ambulatory clinics were obtained from medical records, and quantitative assessment of factors affecting it was based on structured interviews with parents at baseline. Qualitative analysis was based on home visits or telephone in-depth interviews conducted about 1 year post-discharge, to obtain a rich, multilayered, experiential perspectives and explained perceptions by parents. Adherence to post-discharge referrals was generally good, but environmental, cultural, and financial obstacles to healthcare, magnified by communication barriers, forced parents with limited resources to make difficult choices affecting utilization of healthcare services. Improving concordance between primary caregivers and health care providers is crucial, and further development of supportive healthcare for CSHCN in concordance with parental limitations and preferences is needed.
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Metadata
Title
Understanding Utilization of Outpatient Clinics for Children with Special Health Care Needs in Southern Israel
Authors
Hagit Peres
Yael Glazer
Daniella Landau
Kyla Marks
Hana’a Abokaf
Ilana Belmaker
Arnon Cohen
Ilana Shoham-Vardi
Publication date
01-10-2014
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 8/2014
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-013-1427-2

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