title: How Much Time Do Families Spend on the Health Care of Children with Diabetes?
abstract: BACKGROUND
  Family 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.
  
  
  METHODS
  Data 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.
  
  
  RESULTS
  Nearly 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.
  
  
  CONCLUSIONS
  Health 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.
authors.affiliation: Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA.|Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Miller
authors.affiliation: Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA. cnugent@ifh.rutgers.edu.
authors.forename: Colleen N
authors.initials: CN
authors.lastname: Nugent
authors.affiliation: Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA.|Department of Economics, Rutgers University, New Brunswick, NJ, USA.
authors.forename: Louise B
authors.initials: LB
authors.lastname: Russell
keywords: Care coordination; Children; Diabetes; Family health; Stress; Time