Skip to main content

Open Access Non-reimbursable Workload in Pediatric Diabetes Care – the Providers' Perspective

This article is Open Access under the terms of the Creative Commons CC BY-NC-ND licence.

Objective: In this study, we quantified the amount of time that pediatric diabetes care providers spend in non-reimbursable activities and evaluated the predictors related to clinic structure and educational and behavioral care diabetes support. Methods: We distributed an anonymous electronic survey via email to Pediatric Endocrine Society (PES) members and requested information about their practice and about non-reimbursable time spent during an average week not on call. Results: A total of 96 diabetes providers completed the survey. Most providers spent 1-2 hours a day on non-billable activities and 60% of them worked on weekends. Providers from medium sized programs and those without fellowships saw more patients than providers from small and large programs and those with fellowships. The same groups had the least assistance from certified diabetes care and education specialists (CDCES) and social workers. Providers from practices allowing CDCES to review blood glucose data and adjust insulin spent significantly less time on this activity themselves. Conclusions: We call for the development of new reimbursement models, noting increasing demands of technology, need for longitudinal care between visits and ensuring sustainability and equity of pediatric diabetes care.


Document Type: Research Article

Affiliations: 1: Baystate, Baystate Medical Center Children's Hospital, Division of Pediatric Endocrinology and Diabetes, Springfield, MA, United States 2: Baystate, Baystate Medical Center Children̢Ъs Hospital, Division of Pediatric Endocrinology and Diabetes, Springfield, MA, United States 3: Oregon Health and Science University, Department of Pediatrics, Division of Pediatric Endocrinology, Portland, OR, United States

Publication date: May 1, 2022

More about this publication?
  • Health Behavior and Policy Review is a rigorously peer-reviewed scholarly bi-monthly publication that seeks manuscripts on health behavior or policy topics that represent original research, including papers that examine the development, advocacy, implementation, or evaluation of policies around specific health issues. The Review especially welcomes papers that tie together health behavior and policy recommendations. Articles are available through subscription or can be ordered individually from the Health Behavior and Policy Review site.
  • Editorial Board
  • Information for Authors
  • Submit a Paper
  • Subscribe to this Title
  • Terms & Conditions
  • Associate Editors
  • Institutional Subscription
  • PDF Policy
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content