title: Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.
abstract: OBJECTIVE
  To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance.
  
  
  METHODS
  With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D.
  
  
  RESULTS
  Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P < .0001) and 17% of families of children without special health care needs (P < .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 impact.
  
  
  CONCLUSIONS
  In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact.
authors: Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, MA, USA. michelle.katz@joslin.harvard.edu
authors: Michelle L
authors: ML
authors: Katz
authors: Lori M
authors: LM
authors: Laffel
authors: James M
authors: JM
authors: Perrin
authors: Karen
authors: K
authors: Kuhlthau
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D017281:Cost of Illness; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D019988:Children with Disabilities / Q000706:statistics & numerical data; D022143:Family Nursing / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000191:economics; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D018802:Patient-Centered Care / Q000458:organization & administration*; D011787:Quality of Health Care; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States