title: Health insurance and the financial impact of IDDM in families with a child with IDDM.
abstract: OBJECTIVE
  To examine the health insurance experience and out-of-pocket health care costs of families with a child with IDDM.
  
  
  METHODS
  A case-control study of 197 families with a child with IDDM and 142 control families with no diabetic children was conducted. IDDM-affected families were identified from the Allegheny County IDDM Registry. Brothers and sisters of the parents in the IDDM-affected families were asked to participate as control subjects. Health insurance coverage and the money that families spent on health care services and supplies not reimbursed by insurance (out-of-pocket costs) were assessed by questionnaire.
  
  
  RESULTS
  No difference was found between the IDDM-affected and control families in the percentages with or without insurance. Families with low household incomes ($10,000-$19,999) were at the greatest risk for having no insurance. While coverage provided by private plans was similar between the IDDM-affected and control families, many families had no reimbursement for insulin (10%), syringes (10%), or blood testing strips (30%). Out-of-pocket expenses were 56% higher in the IDDM-affected families than in the control families. Seventeen percent of the IDDM-affected families had expenses over 10% of their household income. This particularly affected families with low household incomes. Pre-existing illness clauses and insurance denial affected only a small proportion of the case families.
  
  
  CONCLUSIONS
  These data illustrate that most families with a child with IDDM have health insurance, yet still incur larger out-of-pocket health care costs than do families without the presence of diabetes. IDDM-affected families likely face a number of economic decisions regarding health insurance and the use of health care.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA. tjs@vms.cis.pitt.edu
authors.forename: T J
authors.initials: TJ
authors.lastname: Songer
authors.forename: R
authors.initials: R
authors.lastname: LaPorte
authors.forename: J R
authors.initials: JR
authors.lastname: Lave
authors.forename: J S
authors.initials: JS
authors.lastname: Dorman
authors.forename: D J
authors.initials: DJ
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D002388:Catastrophic Illness / Q000191:economics / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000191:economics*; D004493:Education; D004630:Emergencies; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D007182:Income; D007223:Infant; D007348:Insurance, Health; D008297:Male; D009679:Nuclear Family; D010414:Pennsylvania; D015406:Single Parent; D012959:Socioeconomic Factors; D044465:White People