1. Results Demographics Clinical Characteristics Diabetes Care Experiences Background and Aims Achieving equitable quality of care (QOC) for rural families is challenging The aim of this study was to evaluate diabetes care experiences of rural families and compare their experiences to those of families from urban areas Methods Participants Eligibility: Ages 2-18, T1D diagnosis>10 months Enrolled: 34 rural and 27 urban families, defined by zip code Measures QOC survey (adapted from SEARCH For Diabetes in Youth Study’s QOC survey) Patient-provider communication (e.g., “How often did your provider involve you as much as you wanted?”) 4 Questions scored on a scale of 0 (never) – 4 (always) Diabetes education (e.g., How to treat hypoglycemia) 7 areas listed and whether they were covered by provider Qualitative questions for rural participants Medical record review of the previous 12 months included insulin regimen, A1C, and diabetes-related hospitalizations Discussion Compared to patients that lived in urban areas, there were more frequent hospitalizations and a greater perceived burden for those who lived in rural areas Factors that contribute to more frequent admissions may include less familiarity with diabetes and less access to endocrinology expertise in a rural area, making it more difficult to determine whether a diabetes-related illness requires hospital admittance Connor Mitrovich 1, Joyce P. Yi-Frazier 1,2, Michael Pascual 1, Neil Panlasigui 1, Natalie Beauregard 1, Katherine Cochrane 1, Catherine Pihoker 1,2,3, Faisal Malik 1,2,3, Kathaleen Briggs Early 4 1 Seattle Children's Research Institute, Seattle, WA 2 University of Washington, Pediatrics, Seattle, WA 3 Seattle Children’s Hospital, Seattle, WA 4 Pacific Northwest University of Health Sciences, Yakima, WA Clinical Implications and Next Steps Strategize to address local support for families living in rural areas Augment education for families, including web-based services Reduce barriers to help rural patients attend clinic visits Improve support for healthcare providers in rural areas Use of telemedicine Improve partnering in diabetes care delivery Share education modules A Pilot Assessment of Quality of Care in Rural and Urban Youth With Type 1 Diabetes Literature Cited Krishna S, Gillespie KN, McBride TM. Diabetes Burden and access to preventative care in the rural United States. J Rural Health. Winter 2010;26(1):3-11 Coon P, Zulkowski K. Adherence to American Diabetes Association standards of care by rural health care providers. Diabetes Care. Dec 2002;25(12):2224-2229 Johnson EA, Webb WL, McDowall JM, et al. A field-based approach to support improved diabetes care in rural states. Prev Chronic Dis. Oct 2005;2(4):A08 RuralUrban Race (%NHW)74%93% Education Level (> High School)63%74% Income (% < $50K/year)47%22%^ Public Insurance56%15%* Results Continued Rural Patient Experience Questions Why did rural patients travel so far for care? 44%: “it is worth it to receive the best possible care” 33%: “no other option” The majority (67%) of the participants endorsed that travel was a hardship, particularly in regards to the financial impact of travel and time off from work *p=.001, ^p=.05 *p=.005 *p=.01 *p=.04 * Seattle RuralUrban A1C (M ± SD)9.0 ± 1.88.5 ± 1.6 Insulin Regimen (% Pump)47%63% 143 mi. * * % of patients who attended at least 4 clinic visits (in the 12 Months Prior to Survey Completion) June 2015