The Impact of Telemedicine on Quality of Care for Patients with Diabetes After March 2020.
J Gen Intern Med
; 37(5): 1198-1203, 2022 04.
Article
in En
| MEDLINE
| ID: mdl-35091921
ABSTRACT
BACKGROUND:
The impact of telemedicine on ambulatory care quality is a key question for policymakers as they navigate payment reform for remote care.OBJECTIVE:
To evaluate whether utilizing telemedicine in the first 9 months of the COVID-19 pandemic impacted performance on a diabetes quality of care measure for patients at a large academic medical center. We hypothesized care quality would reduce less among telemedicine users.DESIGN:
Quasi-experimental design using binomial logistic regression. Covariates included age, gender, race, ethnicity, type of insurance, hierarchical condition category score, primary language at the individual level, and zip code-level income.PARTICIPANTS:
All adult patients younger than 75 years of age diagnosed with type 2 diabetes mellitus (N = 16,588) as of 3/19/2020 at a single academic health center.INTERVENTIONS:
Completion of one or more telemedicine encounters with an institutional primary care physician or endocrinologist between 3/19/2020 and 12/19/2020. MAINMEASURES:
The components met in a five-item composite measure of diabetes quality of care, as of patients' last clinical encounter. Items were (1) systolic blood pressure less than 140 mmHg, (2) hemoglobin A1c less than 8.0%, (3) using a statin and (4) aspirin, and (5) tobacco non-use. KEYRESULTS:
From the pre- to post-period, the probability of meeting any given component of the composite measure for patients only utilizing in-person care was 21% lower (OR, 95% CI 0.79; 0.76, 0.81) and for the telemedicine users 2% lower (OR 0.98; 0.85, 1.13). There was an increased likelihood of meeting any given component among telemedicine users compared to in-person care alone (OR 1.25; 1.08, 1.44).CONCLUSIONS:
Patients with diabetes utilizing telemedicine performed similarly on a composite measure of diabetes care quality compared to before the pandemic. Those not utilizing telemedicine had reductions. Telemedicine use maintained quality of care for patients with diabetes during the first 9 months of the COVID-19 pandemic.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Telemedicine
/
Diabetes Mellitus, Type 2
/
COVID-19
Limits:
Adult
/
Humans
Language:
En
Journal:
J Gen Intern Med
Journal subject:
MEDICINA INTERNA
Year:
2022
Document type:
Article
Affiliation country:
Estados Unidos