Expansion of Medicaid Coverage of Continuous Glucose Monitor Reduces Health Disparity in Children and Young Adults With Type 1 Diabetes Article Swipe
Brian Miyazaki
,
Troy Zeier
,
Rebecca Ortiz La Banca
,
Juan Espinoza
,
Lily C. Chao
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/19322968241287217
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/19322968241287217
Background: Continuous glucose monitor (CGM) usage improves glycemia in people with type 1 diabetes (PWD) and is accepted as the standard of care. The CGM utilization is lower in patients with public insurance and minorized ethnicities. In 2022, California Medicaid reduced its barriers to obtaining CGM coverage for PWD. It is unknown whether this policy change is sufficient to increase CGM usage. We hypothesize that the change in Medicaid coverage improved CGM uptake in children and young adults with T1D. Methods: Data were extracted from electronic medical record of a large urban children’s hospital in 2021 and 2022. The CGM usage was determined based on clinician documentation or the presence of CGM downloads. Kruskal-Wallis tests, Wald tests, and χ 2 tests were used to test hypothesis ( P < .05). Mixed effects logistical regression analyses were performed. Results: We included 878 and 892 PWD (age ≤ 21 years) in 2021 and 2022, respectively. In 2022, Medicaid insured 59.3% of patients. Between 2021 and 2022, CGM usage did not change for privately insured patients (84%) but increased from 41% to 58% for patients receiving Medicaid. In our mixed effects logistic regression model, CGM usage was higher in 2022 and in English speakers. Public insurance, black race, and patients’ age were negatively associated with CGM usage. Conclusion: Our results suggest that Medicaid expansion of CGM coverage increases its utilization for pediatric PWD but did not eliminate the disparity. Future studies are needed to identify barriers that preclude equity in technology uptake.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/19322968241287217
- OA Status
- green
- Cited By
- 1
- References
- 31
- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4403401257Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1177/19322968241287217Digital Object Identifier
- Title
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Expansion of Medicaid Coverage of Continuous Glucose Monitor Reduces Health Disparity in Children and Young Adults With Type 1 DiabetesWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-10-14Full publication date if available
- Authors
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Brian Miyazaki, Troy Zeier, Rebecca Ortiz La Banca, Juan Espinoza, Lily C. ChaoList of authors in order
- Landing page
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https://doi.org/10.1177/19322968241287217Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/11571635Direct OA link when available
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Medicaid, Medicine, Logistic regression, Type 1 diabetes, Continuous glucose monitoring, Diabetes mellitus, Medical record, Demography, Health care, Environmental health, Emergency medicine, Internal medicine, Endocrinology, Sociology, Economics, Economic growthTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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