Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

Introduction: Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020.

Method: Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analysis.

Results: The final sample included 17,065 CYSHCN. In the fully adjusted analysis, there was a significant decrease in odds of accessing preventive dental care (adjusted odds ratio [AOR], 0.63; 95%confidence interval [CI], 0.51-0.77) and increased odds of unmet mental health care needs (AOR,1.34; 95% CI, 1.02-1.77). The inability to obtain an appointment was a barrier that increased during the study period (AOR, 2.77; 95% CI, 1.71-4.46).

Discussion: Novel pandemic related policies may have mitigated negative impacts on health care access for CYSHCN.