Abstract
IntroductionFamily time caring for children with diabetes is an overlooked component of the overall burden of the condition. We document and analyze risk factors for time family members spend providing health care at home and arranging/coordinating health care for children with diabetes.MethodsData for 755 diabetic children and 16,161 non-diabetic children whose chronic conditions required only prescription (Rx) medication were from the 2009–2010 United States National Survey of Children with Special Health Care Needs (NS-CSHCN). We used generalized ordered logistic regressions to estimate adjusted odds ratios (AORs) of time burden by diabetes, insulin use, and stability of the child’s health care needs, controlling for health and socioeconomic status.ResultsNearly one-quarter of diabetic children had family members who spent 11+ h/week providing health care at home, and 8% spent 11+ h/week arranging/coordinating care, compared with 3.3% and 1.9%, respectively, of non-diabetic Rx-only children. Time providing care at home for insulin-using children was concentrated in the higher time categories: AORs for insulin-using diabetic compared to non-diabetic Rx-only children were 4.4 for 1+ h/week compared with <1 h/week, 9.7 for 6+ vs. <6 h, and 12.4 for 11+ vs. <11 h (all P < 0.05); the pattern was less pronounced for non-insulin-using children. AORs for arranging/coordinating care did not vary by time contrast: AOR = 4.2 for insulin-using, 3.0 for non-insulin-using children.ConclusionHealth care providers, school personnel, and policymakers need to work with family members to improve care coordination and identify other ways to reduce family time burdens caring for children with diabetes.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-016-0181-z) contains supplementary material, which is available to authorized users.
Highlights
Time caring for children with diabetes is an overlooked component of the overall burden of the condition
For example, 73.0% of non-CSHCN required minimal time from family members for providing and arranging health care compared with 53.9% of non-diabetic Rx-only children
Contrasts of diabetic children with children from the general population, were such contrasts possible in the 2009–2010 survey, would show larger differences than those presented below. This should be kept in mind for the rest of the results, which compare diabetic children to non-diabetic Rx-only children
Summary
Time caring for children with diabetes is an overlooked component of the overall burden of the condition. We document and analyze risk factors for time family members spend providing health care at home and arranging/coordinating health care for children with diabetes. Enhanced content To view enhanced content for this article go to http://www.medengine.com/Redeem/ 3ED4F0605DE46151. Almost 90% of children in the US who have diabetes have type 1 [1], which requires careful coordination of blood glucose monitoring and insulin administration with dietary intake and physical activity to avoid hypoglycemic or hyperglycemic episodes [8]. For children with type 2 diabetes [9, 10], which is associated with obesity, management includes medication and monitoring diet and physical activity to promote a healthy weight [9]. Other necessary tasks for managing diabetes include arranging and keeping appointments with primary care providers, specialists, and diabetes educators [11]
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