Objective: Novel Interventions in Children’s Healthcare (NICH) is an ecologically valid intervention for youth with T1D who experience avoidable acute complications. While NICH has been associated with reductions in DKA events, the true impact of NICH is unclear without a control group. This study compares NICH youth utilization over time to youth referred to but denied NICH by insurance (i.e., unserved).

Methods: Medical providers referred youth with T1D who experienced avoidable utilization to NICH (n=110). Unserved youth (n=50) were more likely than NICH youth (n=60) to have commercial insurance and less accessible medical records. There were no demographic differences between the groups (M age=14.0 years; 58% were female; 79% were non-Hispanic white). Medical record review included 1 year prior to and 2 years following NICH.

Results: NICH youth had more documented hospital admissions and ED visits in the year prior to services (p<.05) than unserved youth. Compared to unserved youth, NICH youth experienced a greater reduction in days admitted during the 1st year and in DKA events in the 2nd year post-initiation (p<.05).

Conclusions: This study was the first to compare NICH to a control group. NICH youth demonstrated greater reductions in acute complications following treatment; however, findings indicate that these groups were different in important ways, likely under capturing control group utilization following referral.

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Disclosure

D.V. Wagner: None. C. Jenisch: None. N.C. Koskela-Staples: None. I. Guttmann-Bauman: None. C.E. Larsen: None. L. Teplitsky: None. M.A. Harris: None.

Funding

The Leona M. and Harry B. Helmsley Charitable Trust

© 2019 by the American Diabetes Association.
2019
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