AbstractObjective Parent-reported need for subspecialty care has the potential to be influenced by factors such as access to primary care, supplier-induced demand, and parent health literacy. We sought to model predicted likelihood of need for subspecialty care based on objective clinical factors, and to compare this "predicted need" to parent-reported need and actual receipt of subspecialty care across sociodemographic groups. Methods The 2022-23 National Survey of Children's Health captures parent-reported need for subspecialty care. We modeled the association between parent-reported need for subspecialty care and clinical factors (child age, health status, presence and severity of specific conditions) and used this model to generate "predicted need." We compared weighted percentages of predicted need, parent-reported need, and actual receipt by family poverty level, child race, payer, and family language. Results Of 90,620 unweighted children included, predicted need for subspecialty care was highest for those with lowest family income (Conclusion Gaps between predicted need and parent-reported need for subspecialty care were larger for populations underserved by the US health care system. Predicted need for subspecialty care may serve as an alternative means of estimating underlying population need for subspecialty care.
Legg et al. (Sun,) studied this question.