Impact of Type 1 Diabetes Mellitus on the Family is Reduced with the Medical Home, Care Coordination, and Family-Centered Care

Abstract

Objectives: To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes (T1D) on families’ work, finances, time, and school attendance. Study design: Using the 2005–2006 National Survey of Children with Special Health Care Needs, we compared impacts among children with T1D (n=583), with other special health care needs (n=39,944), and without special health care needs (n=4,945). We modeled the associations of the medical home, care coordination and family-centered care with family impacts in T1D. Results: In families of children with T1D, 75% reported a major impact versus 45% of families of children with special health care needs (p<0.0001) and 17% of families of children without special health care needs (p<0.0001). In families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care and 20% reported ≥11 school absences/year. The medical home, care coordination and family-centered care were associated with less work and financial impacts. Conclusions: In childhood T1D, most families experience major impacts. Better systems of health care delivery may help families reduce some of these impacts.