Employment change and the role of the medical home for married and single-mother families with children with special health care needs

DeRigne, LeaAnne; Porterfield, Shirley L.

doi:10.1016/j.socscimed.2009.10.054

Cited by 50 publications

(52 citation statements)

References 27 publications

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“…() identified the same components—familty‐centered care, care coordination, and obtaining needed referrals—as associated with lowered odds of a parent having reduced or quit paid employment to care for the CSHCN. DeRigne and Porterfield (), Kuhlthau et al. (), and Kogan et al.…”

Section: Discussionmentioning

confidence: 99%

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Which Components of Medical Homes Reduce the Time Burden on Families of Children with Special Health Care Needs?

Miller¹,

Nugent

Russell

2014

Health Services Research

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Objectives. To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home. Data Sources. [2009][2010] National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 CSHCNs. Study Design. NS-CSHCN is a cross-sectional, observational study. We used generalized ordered logistic regression, testing for nonproportional odds in the associations between each of five medical home components and time burden, controlling for insurance, child health, and sociodemographics. Data Collection/Extraction Methods. Medical home components were collected using Child and Adolescent Health Measurement Initiative definitions. Principal Findings. Family-centered care, care coordination, and obtaining needed referrals were associated with 15-32 percent lower odds of time burdens arranging/ coordinating and 16-19 percent lower odds providing health care. All five components together were associated with lower odds of time burdens, with greater reductions for higher burdens providing care. Conclusions. Three of the five medical home components were associated with lower family time burdens arranging/coordinating and providing health care for children with chronic conditions. If the 55 percent of CSHCNs lacking medical homes had one, the share of families with time burdens arranging care could be reduced by 13 percent.

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Section: Discussionmentioning

confidence: 99%

“…; Okumura et al. ; DeRigne and Porterfield ; Kuo, Bird, and Tilford ; Katz et al. ), and combinations of those burdens (Viner‐Brown and Kim ; Kogan et al.…”

mentioning

confidence: 99%

Which Components of Medical Homes Reduce the Time Burden on Families of Children with Special Health Care Needs?

Miller¹,

Nugent

Russell

2014

Health Services Research

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“…Maintaining a job while simultaneously needing to be absent from work for doctor's appointments is practically an impossible scenario for many caregivers. Consequently, parents often reduce work hours or give up employment entirely in order to provide needed care (DeRigne & Porterfield, 2010). One United Kingdom study found that only two percent of mothers with one severely disabled child work full-time outside the home, this drops to one percent of mothers with two severely disabled children (Lawton, 1998a).…”

Section: Parental Employmentmentioning

confidence: 99%

“…Indeed, several studies have found that the way a child receives medical treatment influences parental employment (DeRigne & Porterfield, 2010;Okumura et al, 2009;Turchi et al, 2009). When children are treated in a medical home (having a usual source of care, family-centered care, receiving care coordination, and receipt of needed referrals) a parent's risk of cutting work hours is reduced by 51% and the risk of stopping work all together is cut by 64% (DeRigne & Porterfield, 2010).…”

Section: Care Coordination In a Medical Homementioning

confidence: 99%

Material hardship in families with children with health conditions: Implications for practice

Stoddard-Dare

DeRigne

Quinn

et al. 2015

Children and Youth Services Review

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Cross-sectional data from the third wave of a ten-year data collection initiative were used to assess the odds of experiencing four material hardships between families who have a child member with a limiting health condition, and families with children who do not have a child member with a limiting health condition. The odds of experiencing material hardship in families with more than one child with a limiting health condition were also assessed. In the multivariable models, having a child in the household with a limiting health condition increases the odds the household will be unable to pay bills, and have their phone service disconnected. Also, having more than one child in a household with a limiting health condition increases the odds of being unable to pay bills, having a phone disconnected, and receiving food stamps. Interventions to assist these vulnerable families are presented.

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“…Stratification of this population is essential in order to appropriately allocate limited resources [7, 8], particularly since 1 % of patients with the highest level of medical complexity at any one time account for over one-third of pediatric health care cost based on insurance charges [9], which does not include the additional costs to families and caregivers that exist in regards to actual expenditures, lost wages, and psychosocial stress. Prior research demonstrates that effective out-patient primary care can improve health outcomes and decrease costs for CSHCN [10–13], but in order to accomplish such goals one must first be able to identify this population of children within a clinic setting.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Identify and Stratify Children with Special Health Care Needs in Outpatient General Pediatrics Settings

Davis

McFadden

Patterson

et al. 2014

Matern Child Health J

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Developing improved systems of care for children with special health care needs (CSHCN) requires accurate identification and stratification of this population. This study was designed to assess the ability of a brief screener to identify and stratify CSHCN in a primary care clinic to focus future quality improvement initiatives and allocate resources. All families presenting for health maintenance visits or acute care appointments at an academic primary care clinic between September 5, 2012 and September 28, 2012 were asked to complete the CSHCN Screener©. This panel of patients was compared to registries previously created by: (1) retrospective chart reviews using published lists of International Statistical Classification of Diseases and Related Health Problems (ICD9) codes for CSHCN and (2) direct physician referral to a clinic case manager providing care coordination services to CSHCN. Screeners identified 246 CSHCN (16.8 % of unique completed screeners). Scores ranged from 0 to 5; higher scores indicate higher levels of complexity. Patients with positive screens had a mean score of 2.4. Patients previously identified by retrospective ICD9 search who completed a screener had a mean score of 1.6 with nearly one-half having negative screens. Patients previously identified by physician referral who completed a screener had a mean score of 2.7 with nearly one-half having scores of 4 or 5. The CSHCN Screener© can be utilized in an academic primary care clinic to prospectively identify CSHCN and potentially offers a more clinically meaningful method of identification given its inherent ability to stratify this population based on complexity of medical needs.

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Employment change and the role of the medical home for married and single-mother families with children with special health care needs

Cited by 50 publications

References 27 publications

Which Components of Medical Homes Reduce the Time Burden on Families of Children with Special Health Care Needs?

Which Components of Medical Homes Reduce the Time Burden on Families of Children with Special Health Care Needs?

Material hardship in families with children with health conditions: Implications for practice

Strategies to Identify and Stratify Children with Special Health Care Needs in Outpatient General Pediatrics Settings

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