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Children with special healthcare needs are children with chronic physical, developmental, behavioral, or emotional conditions that require health and related services beyond what is required by children in general.1,2 This population accounts for about 16% of children in the United States,3,4 accounts for 40% to 80% of all pediatric healthcare utilization and costs, and is the fastest-growing group in pediatrics.3,5,6,7,8,9 Compared to children without chronic conditions, children with chronic conditions tend to be older, male, and from non-Hispanic white racial/ethnic groups.4,6,10,11 The clinical spectrum of conditions is diverse, and complex medical devices are often required for care (Tables 146-1 and 146-2).6,8,9,10,12,13,14

TABLE 146-1Congenital or Developmental Disorders and Associated Medical Conditions15,16

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