Understanding factors associated with work loss for families caring for CSHCN.
OBJECTIVE
Parents of children with special health care needs (CSHCN) are at risk for work loss as a result of the complex health needs of their children. Our objective was to determine how child- and family-level factors and the medical home are associated with work loss for these families.


METHODS
We performed secondary data analyses of the National Survey of Children With Special Health Care Needs (NS-CSHCN) 2005-2006. This is a nationally representative sample of CSHCN in the United States. The primary outcome measure was having any family member report work loss to care for a CSHCN. We calculated survey-weighted unadjusted and adjusted odds ratios by using independent variables that included child demographic factors, functional limitation, condition stability, insurance status/type, family income, and criteria of the medical home.


RESULTS
Overall, 23.7% of the parents of CSHCN reported work loss as a result of their child's health care needs. Greater functional limitation and condition instability were associated with increased odds of family work loss. The presence of a medical home in the multivariate model was associated with a 50% reduction in the odds of reported family work loss.


CONCLUSIONS
Approximately 24% of families with CSHCN have experienced work loss to meet the medical needs of their child. Availability of a system of care support, such as the medical home, is associated with lower work loss reported by families. Therefore, improved systems of care for CSHCN may have the potential to optimize work productivity for families.
Okumura
Megumi J
MJ
University of California, Division of General Pediatrics, 3333 California St, Suite 245, San Francisco, CA 94118, USA. okumuram@peds.ucsf.edu
Van Cleave
Jeanne
J
Gnanasekaran
Sangeeth
S
Houtrow
Amy
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D015999:Multivariate Analysis; D020380:Needs Assessment / Q000191:economics / Q000706:statistics & numerical data*; D016017:Odds Ratio; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D014478:Unemployment / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology