The employment and financial effects on families raising children with special health care needs: an examination of the evidence.
BACKGROUND
Over 10 million children in the United States have special health care needs (U.S. Department of Health & Human Services, 2008). Parents struggle to afford needed health care and wrestle with the dual responsibilities of caregiving and employment. Researchers from a variety of disciplines, health care, and social science, in particular, are analyzing what variables affect a family's ability to access needed health care while balancing work and caregiving.


METHODS
A systematic literature review was conducted on the past 11 years of research that examined insurance status, insurance type, family out-of-pocket expenses, employment outcomes (reductions in hours or stopping work all together), and the role of receiving care in a medical home.


RESULTS
It was found that private health insurance, more severe conditions, and specific diagnoses are related to increased expenses and employment changes. It was also found that receiving care in a medical home reduces both.


CONCLUSIONS
It is vital that clinicians and policy makers move forward in expanding the concept of the medical home model as a means to improving the well-being of families raising children with special health care needs.
Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, USA. lderigne@fau.edu
LeaAnne
L
DeRigne
D000293:Adolescent; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D002675:Child, Preschool; D003657:Decision Making; D019988:Children with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D004651:Employment / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010290:Parents; D018802:Patient-Centered Care / Q000191:economics / Q000458:organization & administration*; D020954:Single-Parent Family / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology