Cheng Zhu, Xiaopeng Wu
A Study on Differential Effects of Mathematics Reading Ability on Students' Value-Added Mathematics Achievements
Behavioral sciences (Basel, Switzerland)
youths type 2 diabetes higher risk complications compared peers type 1 diabetes though studies evaluated differences access specialty care compare claims diabetes specialists youths type 1 vs type 2 diabetes association specialist claims multidisciplinary acute care utilization crosssectional study used optum clinformatics data mart commercial claims individuals included study youths younger 19 years type 1 2 diabetes determined validated algorithm prescription claims data collected youths least 80 enrollment commercial health plan december 1 2018 december 31 2019 statistical analysis performed september 2022 january 2024 primary outcome number ambulatory claims endocrine andor diabetes physician advanced practice clinician associated diabetes diagnosis code secondary outcomes included multidisciplinary acute care claims claims analyzed 4772 youths mean sd age 136 37 years 4300 901 type 1 diabetes 472 99 type 2 diabetes 2465 517 male 128 27 asian 303 64 black african american 429 90 hispanic latino 3366 705 nonhispanic white 546 114 unknown race ethnicity specialist claims lower type 2 compared type 1 diabetes incidence rate ratio irr 061 95 ci 052072 p 001 propensity scoreweighted analyses presence comorbidity associated increased specialist claims type 1 diabetes irr 107 95 ci 103110 decreased claims type 2 diabetes irr 077 95 ci 067087 pooling diagnosis groups adjusted covariates additional specialist claim associated increased odds claim diabetes care education specialist odds ratio 131 95 ci 125136 dietitian 114 95 ci 109119 behavioral health clinician 116 95 ci 112120 acute care claims additional specialist claim associated increased odds admission 117 95 ci 111124 emergency claims 103 95 ci 098182 crosssectional study found youths type 2 diabetes significantly less likely specialist claims despite insurance coverage indicating barriers care may include medical complexity access diabetes specialists influences engagement multidisciplinary services association increasing ambulatory clinician services admissions suggests high utilization subgroup patients greater risk poor outcomes