743-P: Examining the Intersection between Unmet Social Needs, Chronic Disease Comorbidities, and Emergency Room Utilization among Medicaid Beneficiaries with Diabetes

Abstract

Diabetes self-management (i.e., glucose control, medication adherence, healthy behaviors) is important but challenging, especially among low-income populations. Competing priorities such as social needs (i.e., food, housing, safety, financial) and managing comorbidities adds further burden and may affect healthcare utilization. A large Medicaid managed care plan in Louisiana assessed self-reported social needs among clients with type 2 diabetes from July 2018 - June 2019. We examined the number and pattern of social needs and their association with number of chronic disease comorbidities and emergency room (ER) visits from medical claims data in the 12-months prior to completing the social needs assessment. The sample (n=2902) was mostly female (69.2%), >45 years old (71.2%), Black (61.0%), with ≥1 social need (59.9%; mean= 1.12 ± 1.33; range= 0-8), ≥1 comorbidity in addition to diabetes (97.3%; mean= 3.91 ± 2.14; range= 0-13), and a mean of 4.11 ± 5.83 ER visits. Findings revealed a positive association between social needs and comorbidities (χ2= 32.49; p <0.05); the majority (36.8%) of those with 1 social need (n=929) had 3-4 comorbidities, while the majority (41.2%) of those with ≥2 social needs (n=809) had ≥5 comorbidities. GLM results showed positive associations between social needs (0, 1, ≥2) and ER visits (F=3.74, p=.02) and between comorbidities (0-1, 2-3, ≥4) and ER visits (F=61.17, p<.001) but not the interaction of social needs and comorbidities. Post-hoc Tukey tests showed more ER visits for those with ≥2 social needs vs. 1 need and for those with ≥4 comorbidities vs. fewer. Findings suggest that having ≥2 unmet social needs creates an independent and added burden to the effect of comorbidities on ER utilization. Future research will examine whether addressing unmet social needs among Medicaid beneficiaries with type 2 diabetes and comorbidities can reduce ER utilization and improve health-related outcomes. Disclosure N. Verdecias: None. A. McQueen: None. L. Li: None. C.R. Baddam: None. R.E. Smith: None. M. Kreuter: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK115916-01A1)