932-P: Impact of Insurance Source on Health Care Transition Progress in College Youth with Type 1 Diabetes
Bibliographic record
Abstract
Background: The transition from pediatric to adult models of care can be challenging for adolescents with chronic diseases, like type 1 diabetes (T1D). Among the challenges they often face is the issue of health insurance, which can be difficult to navigate, and which may affect access to effective transitional care. In this study, we examined the impact of insurance source on healthcare transition (HCT) progress in college youth with T1D. Methods: Data are from 138 respondents to a multi-national, web-based study of college youth with T1D recruited via social media platforms and direct outreach. Participants were asked to report their health insurance source and answer questions about the HCT process and their diabetes care team. Descriptive statistics and multivariable regression were used to evaluate HCT measures as a function of sociodemographic variables, adjusting for confounders. Results: Participants were from 85 universities across 30 states and Canada, and 87.0% were covered on a parent’s insurance plan. Those not covered on a parent’s insurance plan were more likely to list a general adult practitioner as their main diabetes care provider (22.2% vs. 8.3%, p=0.067) but were less likely to have received help with finding an adult provider than their counterparts (44.4% vs. 76.3%, p=0.042). Participants not covered on a parent’s insurance plan (vs. those who were) also were more likely to have discussed obtaining health insurance with their provider (61.1% vs. 25.0%, p=0.002). These differences persisted after adjustment. Conclusion: College youth with T1D demonstrate differences in indicators of HCT progress according to insurance source. Lack of parental insurance may instigate independent - though not necessarily smooth - transitions, potentially leaving an increasing number of adolescents with dependent coverage vulnerable to a prolonged HCT. Efforts to improve the HCT process should consider insurance source to advance HCT preparation for all college youth with T1D. Disclosure R. K. Tsevat: None. E. R. Weitzman: None. L. E. Wisk: None. Funding Boston Children’s Hospital (FP01017994)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".