(HE-002) AI-Driven Microeconomic Simulations and Gamified SDOH Nudges to Prevent High-Cost Skin Grafts in Wound Care

Chronic wounds impact 6.7 million Americans annually, with skin grafts averaging $10,000 per case and complications escalating costs by $2,000-$5,000, often driven by social determinants of health (SDOH) such as income volatility from gig work and housing instability. These factors contribute to 40-60% of poor wound outcomes, including delayed healing and graft failure, exacerbating health disparities where underserved populations experience 30% worse results. Existing interventions overlook the microeconomic trade-offs (e.g., budgeting constraints leading to nutritional deficits) that causally impair tissue repair and increase infection risks. This abstract introduces EconWell WoundShield, an AI-powered platform that simulates these SDOH influences to prevent escalation to high-cost grafts through gamified nudges.

Methods:

EconWell WoundShield employs agent-based microeconomic simulations (built with Python and Mesa libraries) to model user-specific SDOH impacts on wound and graft outcomes. Users input anonymized data from sources like gig economy apps or budgeting tools via secure APIs. The AI generates personalized "what-if" scenarios (e.g., unstable housing increasing graft rejection by 30% due to environmental moisture). Gamified challenges deliver nudges, such as 7-day nutrition budgeting streaks rewarding points redeemable for wound supplies vouchers. The platform remains non-clinical, focusing on preventive behaviors, with blockchain-enabled privacy (zero-knowledge proofs) for data sharing. Beta testing involved 500 simulated users in diabetic cohorts, with challenges adaptive to economic constraints.

Results:

In simulated pilots, the platform achieved 20% adherence to SDOH nudges, projecting a 15-25% reduction in graft risks through improved factors like nutrition (reducing collagen deficits) and housing stability (lowering infections by 30%). For high-cost grafts, this translated to 20% fewer referrals and $2,000-$5,000 savings per case via averted complications. Aggregated data indicated 3-5x ROI for health insurers from prevented readmissions, with spillovers including 10% lower mortality risks for life insurers from reduced sepsis. User engagement metrics showed 15-20% better retention compared to non-gamified tools.

Discussion:

EconWell WoundShield demonstrates that gamified microeconomic simulations can empower patients to optimize SDOH, preventing escalation to $10,000+ skin grafts and addressing wound care disparities in value-based models. By quantifying causal links (e.g., income trade-offs to healing delays), it offers scalable ROI for insurers, with potential for cross-sector partnerships (e.g., property insurers benefiting from stable homes). Future real-world pilots will validate these projections, potentially saving billions in wound costs while promoting equity. This innovative approach bridges economic behaviors and health outcomes without clinical intervention.