Full-Time or Working Caregiver? A Health Economics Perspective on the Supply of Care for Type 1 Diabetes Patients

Type 1 diabetes mellitus (T1DM) is a chronic disease requiring lifelong insulin treatment. T1DM patients require care given not only by themselves but also by their family members, particularly in childhood-onset cases. This study aims to identify the relationship between health expenditure, HbA1c and other health outcomes and the socio-economic status of patients and their families, with a focus on family employment status, i.e., whether the caregiver is employed or is a homemaker. To clarify the relationship between the level of health, such as expenditure on health care and HbA1c, and the socioeconomic status of patients and their families, we focus on whether they are “potential full-time caregivers”. Using this analysis, we estimated the hypothetical health care expenditure and HbA1c and showed that male patients have higher expenditure and lower HbA1c when their caregiver is a potential full-time caregiver, whereas younger female patients have higher health care expenditure and lower HbA1c when their caregiver is employed. This finding is not meant to serve as criticism of health care policy in this area; rather, the aim is to contribute to economic policy in Japan for T1DM patients 20 years and older.