1954-LB: Health Care Resource Utilization in Newly Diagnosed Children with Type 1 Diabetes in U.S. Clinical Practice

Introduction & Objective: There are limited contemporary data available on healthcare resource utilization (HCRU) in children newly diagnosed with type 1 diabetes (T1D). This study estimated HCRU in newly diagnosed pediatric patients with T1D in US clinical practice.

Methods: Merative MarketScan^® data were retrospectively analyzed for newly diagnosed pediatric patients with T1D enrolled in Commercial or Medicaid health plans (January 1, 2014-June 30, 2019). Included patients had ≥2 T1D claims ≥30 days apart (first claim was index date), ≥12 months of pre-index enrollment, ≥1 month of follow-up, and were aged <18 years at index. Outcomes included T1D-related inpatient care, TD1-related outpatient visits, and emergency room (ER) visits and hospitalizations for hypoglycemia.

Results: We identified 4092 patients in Commercial and 1153 patients on Medicaid plans (mean [SD] age: 10.5 [4.3] vs 11.1 [4.1] years; 44.5% vs 51.4% female); median (range) follow-up was 27.9 (1.2-54.0) versus 24.7 (1.2-54.0) months. Almost all patients experienced T1D-related outpatient care (Commercial 99.3%; Medicaid 97.3%). T1D-related inpatient care (42.3% vs 36.0%) and use of insulin pumps (45.8% vs 30.5%) and continuous glucose monitoring (66.1% vs 51.9%) appeared higher for patients on Commercial versus Medicaid plans. ER visits for hypoglycemia occurred in 4.4% of patients on Commercial plans and 7.3% of patients on Medicaid plans. Few patients were hospitalized for hypoglycemia (Commercial 0.7%; Medicaid 1.0%).

Conclusion: Newly diagnosed T1D in children was associated with generally high rates of T1D-related HCRU. Distinct disparities in HCRU were identified between Commercial and Medicaid plan participants. Patients in Medicaid plans had higher ER visits for hypoglycemia compared to those with Commercial plans. Medicaid plan participants had lower use of continuous glucose monitoring and insulin pumps.