Needs beyond coverage: Health care inequities among children with disabilities of parents with disabilities

Background: Family aggregation of disability is not uncommon. Research on children with disabilities has often overlooked a specific group facing health disparities: children with disabilities of parents with disabilities.

Objective: To determine whether children with disabilities, whose parents also have disabilities, experience limited access to health care.

Methods: This is a dynamic cohort study. The data used in this study were the 2017-2021 Taiwan's National Disability Registry and the National Health Insurance claims data. All children were matched to their biological fathers and mothers using a unique anonymous identification number to identify the disability status of the children and their parents and the receipt of health care services by the children.

Results: In 2021, a total of 2 834 870 pairs of children and parents were identified, of whom 53,419 were children with disabilities. Of these, 5188 had at least one parent with disabilities. Compared with children whose parents did not have disabilities, those whose parents both had disabilities had 1.71 fewer outpatient visits per year (P = .013). Compared with children whose parents had no disabilities, those whose parents had disabilities had 5.0 and 4.2 fewer general outpatient visits at birth (P < .001) and at the age of 2 years (P < .001), respectively. The magnitude of this effect decreased as the children's age increased.

Conclusions: Children with disabilities whose parents also have disabilities may underutilize health care even in settings such as Taiwan, where universal health coverage is available. Standard health programs do not eliminate health care utilization disparities for such children.