Abstract
Introduction: Does telehealth decrease health disparities by improving connections to care or simply result in new barriers for vulnerable populations who often lack access to technology? This study aims to better understand the role of telehealth and social determinants of health in improving care connections and outcomes for Community Health Center patients with diabetes. Methods: This retrospective analysis of Electronic Health Record (EHR) data examined the relationship between telehealth utilization and glycemic control and consistency of connection to the health care team (“connectivity”). EHR data were collected from 20 Community Health Centers from July 1, 2019 through December 31, 2021. Descriptive statistics were calculated, and multivariable linear regression was used to assess the associations between telehealth use and engagement in care and glycemic control. Results: The adjusted analysis found positive, statistically significant associations between telehealth use and each of the 2 primary outcomes. Telehealth use was associated with 0.89 additional months of hemoglobin A1c (HbA1c) control (95% confidence interval [CI], 0.73 to 1.04) and 4.49 additional months of connection to care (95% CI, 4.27 to 4.70). Discussion: The demonstrated increased engagement in primary care for telehealth users is significant and encouraging as Community Health Center populations are at greater risk of lapses in care and loss to follow up. Conclusions: Telehealth can be a highly effective, patient-centered form of care for people with diabetes. Telehealth can play a critical role in keeping vulnerable patients with diabetes connected to their care team and involved in care and may be an important tool for reducing health disparities.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 206-214 |
| Number of pages | 9 |
| Journal | Journal of the American Board of Family Medicine |
| Volume | 37 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 2024 |
Funding
This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK092949. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding: This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK092949. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Keywords
- Chronic Disease
- Community Health Centers
- Continuity of Patient Care
- Diabetes Mellitus
- Health Care Disparities
- Health Inequities
- Linear Regression
- Patient Care Team
- Patient-Centered Care
- Quality Improvement
- Retrospective Studies
- Social Determinants of Health
- Telemedicine
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Family Practice
