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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
- Authors:
- DERIGNE Leaanne, PORTERFIELD Shirley
- Journal article citation:
- Social Science and Medicine, 70(4), February 2010, pp.631-641.
- Publisher:
- Elsevier
The authors hypothesised that whether or not a child with special health care needs usual source of care meets the criteria for a “medical home” influences parents’ employment decisions. This study included 38,569 children with special health care needs from birth to age 17 surveyed in the 2005-2006 US National Survey of Children with Special Health Care Needs. The employment model is estimated using multinomial logistic regression with the choice of a parent to maintain current employment, reduce hours, or stop working as the dependent variable. Independent variables were those characterising the needs of the child, the resources of the family, and the socio-demographic characteristics of the family. Components of the medical home variable included: having a usual source of care; family centred care; care coordination services; and receipt of needed referrals. Half of the children met criteria in all four facets. The relative risk of a parent choosing to cut their hours rather than maintain them decreased by 51% if the child had a medical home. The relative risk of choosing to stop work rather than not change decreased by about 64%. Care coordination services in particular reduced the odds of changing employment status. The authors conclude that the medical home is a moderating factor in parental decisions concerning change in employment status.