Pediatric home health care represents a vital system of care for children with disability and medical complexity, encompassing services provided by family caregivers and nonfamily home health care pro...

Forty-seven tertiary referral U.S. children’s hospitals. Patients: Patients 5–18 years old with an underlying neuromuscular or genetic disorder admitted to the ICU following thoracic-lumbar spinal ...

Children with tracheostomy and home ventilation (HV) are at high risk of morbidity and mortality from acute respiratory infections (ARIs).1,2 American Thoracic Society guidelines have helped optimize ...

BACKGROUND AND OBJECTIVES. Aspiration pneumonia is a common cause for hospitalization, especially in children with medical complexity, yet there are no standard definition or clinical practice guideli...

Background: Immunization is a highly cost-effective strategy for preventing and eliminating infectious diseases in children. However, caregivers' hesitancy toward #Vaccines may lead to insufficient #Vaccination coverage. Notably, caregivers of children with special health care needs (CSHCN) exhibit a relatively higher level of #Vaccine hesitancy than caregivers of healthy children. The outbreak of the #COVID19 #coronavirus pandemic may disturb children's immunization. Little is known about the hesitancy of caregivers of CSHCN before, during, and after the #COVID19 #coronavirus pandemic. Objective: To investigate the changes in caregivers’ #Vaccination hesitation of children with special health care needs (CSHCN) before, during, and after the #COVID19 #coronavirus pandemic in China, and to identify associated factors for caregivers’ attitudes towards National Immunization Program (NIP) and non-NIP #Vaccines. Methods: We included 7770 caregivers of CSHCN under the age of 18 years who visited the #Vaccination consultation clinic in the Children’s Hospital, Zhejiang University School of Medicine (Hangzhou, China) from May 2017 to May 2023. General and clinical information was extracted from the immunization evaluation system for CSHCN and medical records. We used Chi-square tests to compare the differences in caregivers’ willingness and hesitation to #Vaccinate their children across the three stages of the #COVID19 #coronavirus pandemic. Multinomial logistic regression models were employed to identify independent variables associated with caregivers’ willingness and hesitation towards NIP and non-NIP #Vaccines. Results: During the #COVID19 #coronavirus pandemic, the percentages of choosing NIP, alternative non-NIP, and non-NIP #Vaccines are higher (26.03%, 57.37%, and 62.73%, respectively) than those at the other two stages. In comparison, caregivers’ hesitation towards NIP and non-NIP #Vaccines is lowest (16.60% and 37.27%, respectively). Despite the stages of the #COVID19 #coronavirus pandemic, multiple factors, including children’s age and gender, parents’ educational level, comorbidities, and history of allergy, were significantly associated with caregivers’ attitudes towards NIP and non-NIP #Vaccines (p values

This survey study quantifies state-to-state variation and predictors of Medicaid insurance continuity and adequacy among children with special health care needs.