Examining use of Telehealth During the COVID-19 Pandemic among Patients with Type 2 Diabetes at a Federally Qualified Health Center
ABSTRACT
Background:
The COVID-19 pandemic necessitated an expedited shift towards remote healthcare delivery (e.g., telehealth). Prior research has shown individuals from underserved communities may face greater challenges accessing telehealth services, which could exacerbate existing disparities in chronic conditions, including Type 2 Diabetes (T2D). As patient engagement in telehealth care is likely to persist indefinitely, it is critical to determine whether certain patients may face greater challenges accessing remote care so that appropriate accommodations can be made.
Objective:
To examine factors associated with use of telehealth during the COVID-19 pandemic among adults with T2D at a large federally qualified health center in Southern California.
Methods:
Electronic health records (EHR) from all T2D-related medical visits completed between July 2019 and July 2021 were obtained. The following variables were extracted from the EHR: modality of visit (in person vs. telehealth), patient gender (male, female, non-binary or transgender), age, race/ethnicity (non-Hispanic white, Hispanic, Black, Asian, Middle Eastern/Arabic, Asian-Pacific Islander, Native American or Alaskan, multiracial), income level (below/at vs. above poverty threshold). Patients were trichotomized based on whether they completed at least one telehealth visit following the start of the pandemic, if they completed all visits in person, or if they completed no visits. Chi-square and t-tests were conducted to examine univariate group differences. Multinomial logistic regression was conducted to examine associations between telehealth use and patient sociodemographics.
Results:
Participants included 14,989 patients with T2D (51.7% female, 48.1% male, 0.2% transgender or non-binary; 83.7% Conclusions: While many patients accessed telehealth during the pandemic, observed differences by sociodemographic characteristic suggest some patients may require additional support when accessing remote healthcare. Future research should explore additional factors that could impact telehealth access within underserved communities (e.g., internet/broadband access, language concordance, technology literacy) so that tailored strategies can be developed to facilitate equitable access to care. Clinical Trial: NA
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