{"id":"https://openalex.org/W2016481108","doi":"https://doi.org/10.1542/peds.2006-3308","title":"Financial Burden in Families of Children With Special Health Care Needs: Variability Among States","display_name":"Financial Burden in Families of Children With Special Health Care Needs: Variability Among States","publication_year":2008,"publication_date":"2008-07-01","ids":{"openalex":"https://openalex.org/W2016481108","doi":"https://doi.org/10.1542/peds.2006-3308","mag":"2016481108","pmid":"https://pubmed.ncbi.nlm.nih.gov/18595981"},"language":"en","primary_location":{"id":"doi:10.1542/peds.2006-3308","doi":"https://doi.org/10.1542/peds.2006-3308","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2006-3308","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5006064501","display_name":"Paul T. Shattuck","orcid":"https://orcid.org/0000-0002-2545-3829","observed_orcids":["https://orcid.org/0000-0002-2545-3829"]},"institutions":[{"id":"https://openalex.org/I204465549","display_name":"Washington University in St. Louis","ror":"https://ror.org/01yc7t268","country_code":"US","type":"education","lineage":["https://openalex.org/I204465549"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paul T. Shattuck","raw_affiliation_strings":["George Warren Brown School of Social Work, Washington University, St Louis, Missouri","George Warren Brown School of Social Work, Washington University, Campus Box 1196, St Louis, MO 63130-4899, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"George Warren Brown School of Social Work, Washington University, St Louis, Missouri","institution_ids":["https://openalex.org/I204465549"]},{"raw_affiliation_string":"George Warren Brown School of Social Work, Washington University, Campus Box 1196, St Louis, MO 63130-4899, USA","institution_ids":["https://openalex.org/I204465549"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5102757912","display_name":"Susan L. Parish","orcid":"https://orcid.org/0000-0003-1865-4662","observed_orcids":["https://orcid.org/0000-0003-1865-4662"]},"institutions":[{"id":"https://openalex.org/I114027177","display_name":"University of North Carolina at Chapel Hill","ror":"https://ror.org/0130frc33","country_code":"US","type":"education","lineage":["https://openalex.org/I114027177"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Susan L. Parish","raw_affiliation_strings":["School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina","institution_ids":["https://openalex.org/I114027177"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":15.9738,"has_fulltext":false,"cited_by_count":65,"citation_normalized_percentile":{"value":0.98696924,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"122","issue":"1","first_page":"13","last_page":"18"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.48579999804496765,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.48579999804496765,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":0.26420000195503235,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.1429000049829483,"subfield":{"id":"https://openalex.org/subfields/2003","display_name":"Finance"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/family-financial-burden","display_name":"family financial burden","score":0.8519999980926514},{"id":"https://openalex.org/keywords/children-with-special-health-care-needs","display_name":"children with special health care needs","score":0.9789999723434448},{"id":"https://openalex.org/keywords/out-of-pocket-health-expenditure","display_name":"out-of-pocket health expenditure","score":0.9760000109672546},{"id":"https://openalex.org/keywords/median-family-income","display_name":"median family income","score":0.8550000190734863},{"id":"https://openalex.org/keywords/state-health-policy","display_name":"state health policy","score":0.7250000238418579},{"id":"https://openalex.org/keywords/children-with-chronic-illness","display_name":"children with chronic illness","score":0.3970000147819519}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7579425573348999},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.5022313594818115},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.479465126991272},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3894651234149933},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.38304659724235535},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.13795775175094604},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.09404310584068298},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002671","descriptor_name":"Child, Exceptional","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005102","descriptor_name":"Health Expenditures","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D005190","descriptor_name":"Family","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006306","descriptor_name":"Health Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007182","descriptor_name":"Income","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012959","descriptor_name":"Socioeconomic Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017281","descriptor_name":"Cost of Illness","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019988","descriptor_name":"Children with Disabilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1542/peds.2006-3308","doi":"https://doi.org/10.1542/peds.2006-3308","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2006-3308","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},{"id":"pmid:18595981","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/18595981","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"Comparative Study"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities","score":0.8974000215530396},{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.8371999859809875},{"id":"https://metadata.un.org/sdg/1","display_name":"No poverty","score":0.41670000553131104}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G9000874878","display_name":"Post-Doctoral Training in Intellectual and Developmental Disabilities Research","funder_award_id":"T32HD007489","funder_id":"https://openalex.org/F4320337611","funder_display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development"}],"funders":[{"id":"https://openalex.org/F4320337364","display_name":"National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05"},{"id":"https://openalex.org/F4320337611","display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":26,"referenced_works":["https://openalex.org/W27139926","https://openalex.org/W52618020","https://openalex.org/W1493091238","https://openalex.org/W1976400581","https://openalex.org/W1978309199","https://openalex.org/W1981694520","https://openalex.org/W1991246584","https://openalex.org/W2037922154","https://openalex.org/W2040322182","https://openalex.org/W2041023777","https://openalex.org/W2058744048","https://openalex.org/W2064620396","https://openalex.org/W2071834228","https://openalex.org/W2088082292","https://openalex.org/W2099491410","https://openalex.org/W2110920678","https://openalex.org/W2153589240","https://openalex.org/W2154839228","https://openalex.org/W2156254528","https://openalex.org/W2181343548","https://openalex.org/W2324392187","https://openalex.org/W2901875269","https://openalex.org/W2916466383","https://openalex.org/W2916855524","https://openalex.org/W3022732902","https://openalex.org/W3123574146"],"related_works":["https://openalex.org/W2186705592","https://openalex.org/W7095607515","https://openalex.org/W2169706507","https://openalex.org/W2005243618","https://openalex.org/W2129899135","https://openalex.org/W2040322182","https://openalex.org/W2106802150","https://openalex.org/W2099491410","https://openalex.org/W1766130315","https://openalex.org/W2020973320"],"abstract_inverted_index":{"OBJECTIVE:":[0],"The":[1,59],"main":[2],"objective":[3],"of":[4,16,39,45,85,92,96,134,138,212,244,256],"this":[5,235],"study":[6],"was":[7,150,156],"to":[8,22,76,105,166,174,205,241],"examine":[9,106],"variability":[10,108,236],"among":[11],"states":[12,184],"for":[13,24,113,168,178],"3":[14,196],"indicators":[15],"the":[17,71,77,83,90,119,145,153,210,226,238,242,253],"family":[18,65,97,124,188],"financial":[19,110,129,192,254],"burden":[20,149,155,170,255],"related":[21,75],"caring":[23],"children":[25,42],"with":[26,41,47,52,185,203],"special":[27,48,79,215],"health":[28,49,80,216,222],"care":[29,50,81,217],"needs.":[30],"METHODS:":[31],"Data":[32],"were":[33],"from":[34,56,164,172],"a":[35,53,64],"2001":[36],"national":[37],"survey":[38],"households":[40],"(<18":[43],"years":[44],"age)":[46],"needs,":[51,82],"representative":[54],"sample":[55],"each":[57],"state.":[58],"outcomes":[60],"examined":[61,118],"included":[62],"whether":[63],"had":[66,190],"any":[67],"out-of-pocket":[68,221],"expenditures":[69,137,223],"during":[70],"previous":[72],"12":[73],"months":[74],"child's":[78],"amount":[84,91],"expenditure":[86,93],"(absolute":[87],"burden),":[88],"and":[89,126,152,171,209,233],"per":[94,158,176],"$1000":[95,177],"income":[98,125],"(relative":[99],"burden).":[100],"We":[101,116],"used":[102],"multilevel":[103],"regression":[104],"state-level":[107],"in":[109,183,228],"burden,":[111],"controlling":[112],"individual-level":[114],"factors.":[115],"also":[117],"association":[120],"between":[121],"state":[122,127,161,227,247],"median":[123,187],"mean":[128,146],"burden.":[130,180],"RESULTS:":[131],"Overall,":[132],"82.5%":[133],"families":[135],"reported":[136],"more":[139],"than":[140],"$0.":[141],"Among":[142],"these":[143,257],"families,":[144],"unadjusted":[147],"absolute":[148,169],"$752":[151],"relative":[154,179],"$19.6":[157],"$1000.":[159],"Adjusted":[160],"means":[162],"ranged":[163],"$562":[165],"$972":[167],"$14.5":[173],"$32.3":[175],"Families":[181,199],"living":[182],"higher":[186],"incomes":[189],"lower":[191],"burdens":[193],"across":[194],"all":[195],"measures.":[197],"CONCLUSIONS:":[198],"that":[200],"are":[201],"similar":[202],"respect":[204],"household":[206],"demographic":[207],"characteristics":[208],"nature":[211],"their":[213],"children's":[214],"needs":[218],"have":[219],"different":[220],"depending":[224],"on":[225],"which":[229],"they":[230],"live.":[231],"Documenting":[232],"understanding":[234],"moves":[237],"field":[239],"closer":[240],"goal":[243],"establishing":[245],"evidence-based,":[246],"policy":[248],"recommendations":[249],"aimed":[250],"at":[251],"reducing":[252],"vulnerable":[258],"families.":[259]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":2},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":1},{"year":2020,"cited_by_count":4},{"year":2019,"cited_by_count":5},{"year":2018,"cited_by_count":2},{"year":2017,"cited_by_count":5},{"year":2016,"cited_by_count":2},{"year":2015,"cited_by_count":6},{"year":2014,"cited_by_count":2},{"year":2013,"cited_by_count":3},{"year":2012,"cited_by_count":6}],"updated_date":"2026-11-01T11:40:01.658920","created_date":"2016-06-24T00:00:00"}