Objective: Youth with T1D and high social risk experience health disparities, including acute complications. Novel Interventions in Children’s Healthcare (NICH) , designed to target social risk, is associated with improved health, fewer complications, and lower medical costs. This is the first study to compare NICH outcomes in youth with T1D to a control group using claims data.

Methods: Using a state-based claims database, a difference-in-differences study with a matched comparison group was conducted, comparing youth with T1D served by NICH (n=25) to youth referred to NICH but denied access by insurance or with similar claims history and demographic characteristics (n=47) . Data across a 36-month follow up period were examined.

Results: Mahalanobis matching and entropy balance weighting created well-balanced groups on matched covariates. NICH reduced hospitalizations by 1.6 (p<.01) , ED visits by 4.1 (p<.01) , and cost by >$18k per youth (p<.05) , with maximum impact in the 2nd follow up year (>$9k, p<.01) .

Conclusion: Youth served by NICH had fewer acute medical events and lower costs following NICH initiation than control youth. Youth with complication history did not “regress to the mean,” and continued to experience acute health emergencies - highlighting the potential value of interventions that target youth with T1D and high social risk in need of alternatives to standard medical and behavioral health care.


D.V.Wagner: None. T.Mijanovich: None. S.A.Barry-menkhaus: None. M.A.Harris: None.


The Leona M. and Harry B. Helmsley Charitable Trust

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