Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Diabetes Care. 2021 Jun;44(6):1447-1450. doi: 10.2337/dc20-2712. Epub 2021 Apr 13.
We compared the uptake of telemedicine for diabetes care across multiple demographic groups during the coronavirus disease 2019 pandemic to understand the impact of telemedicine adoption on access to care.
The study analyzed demographic information of patients with type 1 diabetes seen between 1 January 2018 and 30 June 2020 at a single center. We compared the odds of completing a visit via telemedicine across multiple demographic characteristics.
Among 28,977 patient visits, the odds of completing a visit via telemedicine were lower among non-English-speaking (1.7% vs. 2.7%; adjusted odds ratio [aOR] 0.45, 95% CI 0.26-0.79) and Medicaid-insured (32.0% vs. 35.9%; aOR 0.83, 95% CI 0.72-0.95) pediatric patients. No clinically significant differences were observed for other demographic factors.
Rapid transition to telemedicine did not significantly impact access to diabetes care for most demographic groups. However, disparities in access to care for historically marginalized groups merit close attention to ensure that use of telemedicine does not exacerbate these inequities.
我们比较了在 2019 冠状病毒病大流行期间，多个不同人群对糖尿病护理的远程医疗利用率，以了解远程医疗的采用对获得医疗服务的影响。
该研究分析了在单中心就诊的 1 型糖尿病患者在 2018 年 1 月 1 日至 2020 年 6 月 30 日期间的人口统计学信息。我们比较了多个人口统计学特征下通过远程医疗完成就诊的几率。
在 28977 次就诊中，非英语患者（1.7%比 2.7%；调整后比值比[aOR]0.45，95%置信区间[CI]0.26-0.79）和医疗补助保险患者（32.0%比 35.9%；aOR 0.83，95% CI 0.72-0.95）通过远程医疗完成就诊的几率较低。对于其他人口统计学因素，未观察到有临床意义的差异。
远程医疗的快速转型并未显著影响大多数人群获得糖尿病护理的机会。然而，对于历史上处于边缘地位的群体的医疗服务获取方面的差异值得密切关注，以确保远程医疗的使用不会加剧这些不公平现象。
