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Mark A. Schuster, MD, PhD, Paul J. Chung, MD, MS, Marc N. Elliott, PhD, Craig F. Garfield, MD, MAPP, Katherine D. Vestal, MPH and David J. Klein, MS

Mark A. Schuster and Katherine D. Vestal are with the Department of Medicine, Children's Hospital, Boston, MA. Mark A. Schuster, Paul J. Chung, Marc N. Elliott, and David J. Klein are with RAND, Santa Monica, CA. Mark A. Schuster is also with Harvard Medical School, Boston. Paul J. Chung is also with the Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles. Craig F. Garfield is with the Department of Pediatrics, Evanston Northwestern Healthcare, Feinberg School of Medicine, Northwestern University, Evanston, IL.

Correspondence: Requests for reprints should be sent to Mark A. Schuster, MD, PhD, Division of General Pediatrics, Children's Hospital Boston, 300 Longwood Ave, Boston, MA, 02115 (e-mail: mark.schuster{at}childrens.harvard.edu).

Objectives. We examined the perceived effects of leave from work among employed parents of children with special health care needs.

Methods. Telephone interviews were conducted from November 2003 to January 2004 with 585 parents who had missed 1 or more workdays for their child's illness in the previous year.

Results. Most parents reported positive effects of leave on their child's physical (81%) and emotional (85%) health; 57% reported a positive effect on their own emotional health, although 24% reported a negative effect. Most parents reported no effect (44%) or a negative effect (42%) on job performance; 73% reported leave-related financial problems. In multivariate analyses, parents receiving full pay during leave were more likely than were parents receiving no pay to report positive effects on child physical (odds ratio [OR] = 1.85) and emotional (OR = 1.68) health and parent emotional health (OR = 1.70), and were less likely to report financial problems (OR = 0.20).

Conclusions. Employed parents believed that leave-taking benefited the health of their children with special health care needs and their own emotional health, but compromised their job performance and finances. Parents who received full pay reported better consequences across the board. Access to paid leave, particularly with full pay, may improve parent and child outcomes.