Chronic Illness in Children and Foregone Care Among Household Adults in the United States: A National Study.
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pubmed:
3
2
2023
medline:
14
3
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Childhood chronic illness imposes financial burdens that may affect the entire family. The aim was to assess whether adults living with children with 2 childhood chronic illnesses-asthma and diabetes-are more likely to forego their own medical care, and experience financial strain, relative to those living with children without these illnesses. 2009-2018 National Health Interview Survey. Adult-child dyads, consisting of one randomly sampled child and adult in each family. The main exposure was a diagnosis of asthma or diabetes in the child. The outcomes were delayed/foregone medical care for the adult as well as family financial strain; the authors evaluated their association with the child's illness using multivariable logistic regressions adjusted for potential confounders. The authors identified 93,264 adult-child dyads; 8499 included a child with asthma, and 179 a child with diabetes. Families with children with either illness had more medical bill problems, food insecurity, and medical expenses. Adults living with children with each illness reported more health care access problems. For instance, relative to other adults, those living with a child with asthma were more likely to forego/delay care (14.7% vs. 10.2%, adjusted odds ratio: 1.27; 95% CI: 1.16-1.39) and were more likely to forego medications, specialist, mental health, and dental care. Adults living with a child with diabetes were also more likely to forego/delay care (adjusted odds ratio: 1.76; 95% CI: 1.18-2.64). Adults living with children with chronic illnesses may sacrifice their own care because of cost concerns. Reducing out-of-pocket health care costs, improving health coverage, and expanding social supports for families with children with chronic conditions might mitigate such impacts.
Sections du résumé
BACKGROUND
Childhood chronic illness imposes financial burdens that may affect the entire family.
OBJECTIVE
The aim was to assess whether adults living with children with 2 childhood chronic illnesses-asthma and diabetes-are more likely to forego their own medical care, and experience financial strain, relative to those living with children without these illnesses.
RESEARCH DESIGN
2009-2018 National Health Interview Survey.
SUBJECTS
Adult-child dyads, consisting of one randomly sampled child and adult in each family.
MEASURES
The main exposure was a diagnosis of asthma or diabetes in the child. The outcomes were delayed/foregone medical care for the adult as well as family financial strain; the authors evaluated their association with the child's illness using multivariable logistic regressions adjusted for potential confounders.
RESULTS
The authors identified 93,264 adult-child dyads; 8499 included a child with asthma, and 179 a child with diabetes. Families with children with either illness had more medical bill problems, food insecurity, and medical expenses. Adults living with children with each illness reported more health care access problems. For instance, relative to other adults, those living with a child with asthma were more likely to forego/delay care (14.7% vs. 10.2%, adjusted odds ratio: 1.27; 95% CI: 1.16-1.39) and were more likely to forego medications, specialist, mental health, and dental care. Adults living with a child with diabetes were also more likely to forego/delay care (adjusted odds ratio: 1.76; 95% CI: 1.18-2.64).
CONCLUSIONS
Adults living with children with chronic illnesses may sacrifice their own care because of cost concerns. Reducing out-of-pocket health care costs, improving health coverage, and expanding social supports for families with children with chronic conditions might mitigate such impacts.
Identifiants
pubmed: 36730827
doi: 10.1097/MLR.0000000000001791
pii: 00005650-202304000-00002
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-191Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
A.G., D.M.C., D.H., and S.W. are (or have served as) leaders of Physicians for a National Health Program (PNHP), a nonprofit organization that favors coverage expansion through a single payer program. However, none of them receive any compensation from that group, although some of Dr A.G.’s travel on behalf of the organization has been reimbursed by it. N.S. is currently an employee of Treatment Action Group (TAG), a nonprofit research and policy think tank focused on HIV, TB, and hepatitis C treatment. The spouse of Dr A.G. is an employee for Treatment Action Group (TAG). The remaining authors declare no conflict of interest.
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