According to background information in the article, children with special health care needs (CSHCN) are defined as "those children who have or are at increased risk for a chronic physical, developmental, behavioural, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." Compared to other children, CSHCN use more health care services and thus have higher health care costs.

Paul W. Newacheck, Dr.P.H., from the Institute for Health Policy Studies, University of California, San Francisco, and colleagues used data from the 2000 Medical Expenditure Panel Survey in order to examine health care expenditures of CSHCN. A total of 6,965 children under the age of 18 were included in the survey, with 949 (15.6 percent) identified as CSHCN.

In 2000, CSHCN had an average health care expenditure of $2,099, compared to children without special health care needs who had an average expenditure of $628. CSHCN accounted for 42.1 percent of total medical care costs (excluding dental costs) and 33.6 percent of total health care costs (including dental costs) for children. These children also had more than twice as many physician visits and seven times as many non-physician visits than other children, and had average out-of-pocket costs (for all health care) twice that of other children. Average annual expenditures on prescribed medications were ten times higher for CSHCN.

"Our results show that CSHCN use many more services and have significantly higher health care expenses than other children," the authors write. "Health policy changes that would extend the breadth and depth of insurance coverage are needed to ensure that all families of CSHCN are protected against burdensome expenses."; Source: The Archives of Pediatrics & Adolescent Medicine