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1,608 adults with type 1 diabetes adopt automated insulin delivery in four Italian NHS clinics; drives 39.3pp increase in diabetologist visits Complements or Substitutes? Technology Adoption and the Demand for Clinical Care: Evidence from Automated Insulin Delivery Callaway, B., Sant’Anna, P.H.C., 2021. Difference-in-differences with multiple time periods. Journal of Econometrics , 225, 200–230. doi: https: Chandra, A., Skinner, J., 2012. Technology growth and expenditure growth in health care. Journal of Economic Literature , 50, 645–680. doi: https: ...

Adults with type 1 diabetes adopt automated insulin delivery in four Italian NHS clinics; diabetologist visits rise by up to 39.3 pp. Complements or Substitutes? Technology Adoption and the Demand for Clinical Care: Evidence from Automated Insulin Delivery Complements or Substitutes? Technology Adoption and the Demand for Clinical Care: Evidence from Automated Insulin Delivery Moslem Rashidi∗ Cristina Ugolini† Gianluca Fiorentini‡ Department of Economics, University of Bologna Piazza Scaravilli, 40126 Bologna, Italy September 14, 2026 Abstract Whether medical technology reduces or increases demand for professional care is central to assessing its implications for healthcare costs. We study the adoption of automated insulin delivery (AID) among 1,608 adults with type 1 diabetes treated in four specialist clinics of the Italian National Health Service, 283 of whom adopt AID. Because adoption is clinically targeted and staggered, we combine risk-set coarsened exact matching, which retains 181 of the 283 adopters with comparable untreated controls, with a staggered event-study design and adjust for differential pre-adoption trends by extrapolating the untreated trajectory in event time. After adjustment, AID adoption is associated with increased routine outpatient engage- ment. The estimated effect on the probability of a diabetologist visit is 16.3 per- centage points one semester after adoption and rises to 39.3 percentage points four semesters after adoption, against an observed visit probability of 55.2% in the ref- erence semester before adoption. HbA1c testing and a process-of-care index move ∗Corresponding author. Email: moslem.rashidi2@unibo.it. †Email: cristina.ugolini@unibo.it. ‡Email: gianluca.fiorentini@unibo.it. 1 arXiv:2609.12976v1 [econ.GN] 11 Sep 2026 ...