Access to Specialty Care for Commercially Insured Youths With Type 1 and Type 2 Diabetes
Main finding · Specialist claimsResult — go to the resultIncidence rate ratio 0.61 95% CI 0.52–0.72Authors' conclusion
This cross-sectional study found that youths with type 2 diabetes were significantly less likely to have specialist claims despite insurance coverage, indicating other barriers to care, which may include medical complexity. Access to diabetes specialists influences engagement with multidisciplinary services. The association between increasing ambulatory clinician services and admissions suggests high utilization by a subgroup of patients at greater risk for poor outcomes.
Study context
- Population
- Commercially insured youths <19 years with T1D or T2D (validated algorithm and prescription claims), ≥80% enrollment Dec 2018–Dec 2019, Optum Clinformatics Data Mart; mean (SD) age 13.6 (3.7) years
- Participants
- 4,772 participants
- Exposure
- T2D vs T1D
- Type 2 diabetesn = 472
- Type 1 diabetesn = 4,300reference
- Outcome
- Number of ambulatory claims from an endocrine and/or diabetes physician or advanced practice clinician associated with a diabetes diagnosis code
Methodological detailscommercial claims data, propensity score-weighted analyses
- Commercial claims data
- Propensity score-weighted analyses
Main finding
Specialist claims
Incidence rate ratio
0.61
95% CI 0.52–0.72
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Specialist claims with vs without a comorbidity, T1D
- Comorbidity associated with increased specialist claims in T1D
- IRR 1.07 (95% CI 1.03-1.10)
Specialist claims with vs without a comorbidity, T2D
- Comorbidity associated with decreased specialist claims in T2D
- IRR 0.77 (95% CI 0.67-0.87)
Multidisciplinary claims per additional specialist claim (pooled, adjusted)
OR
- Diabetes care and education specialist claim
- 1.31 (95% CI 1.25-1.36)
- Dietitian claim
- 1.14 (95% CI 1.09-1.19)
- Behavioral health clinician claim
- 1.16 (95% CI 1.12-1.20)
- Pooling diagnosis groups, adjusted for covariates
Acute care claims per additional specialist claim
OR
- Admission
- 1.17 (95% CI 1.11-1.24)
- Emergency claims, not increased
- 1.03 (95% CI 0.98-1.82)
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →