Date of Award
Summer 8-25-2023
Document Type
Open Access Thesis
Degree Name
Master of Medical Science (MMSc)
First Advisor
Jonathan Weber, MA, PA-C, DFAAPA
Abstract
Abstract
Telemedicine Slashes ‘No-Show’ Rates and Achieves Comparable Outcomes in Diabetes Care
Jay Gandhi, PA-SII, and Jonathan Weber, MA, PA-C, DFAAPA, Yale Medicine Diabetes Center at Yale-New Haven Hospital, Yale Physician Associate Program
Background
Patients with type 2 diabetes (T2D) require continuous management to achieve optimal outcomes. Patients confronting barriers to care face higher risks of complications. Socioeconomic barriers including inability to afford transportation, work release, childcare or parking fees are factors affecting patient attendance. During the Covid-19 pandemic, telemedicine likely reduced common barriers affecting patient attendance compared to in-person visits. This study investigated the impact of telemedicine on no-show rates and diabetic outcomes in publicly insured patients and the potential link to reduced socioeconomic barriers.
Methods
This retrospective study analyzed records of 819 patients with T2D at the Yale Diabetes Center from June 2019 to December 2020 where in-person and telehealth visits were conducted. No-show rates, glycemic control metrics, and other biomarkers were analyzed and compared in the same patients during distinct in-person and telehealth visit intervals.
Results
Patients utilizing telemedicine averaged no-show rates of 0.34 ± 0.69 compared to 1.19 ± 1.30 (P<0.001) for in-person visits. Average HbA1c for telemedicine visits was 7.93 ± 1.95 compared to 7.91 ± 1.90 (P=0.6489) for in-person visits. Average time in range above 70% on ambulatory glucose profiles was 43.90% for telehealth and 45.42% (P=0.7614) for in-person visits.
Conclusion
Telemedicine visits demonstrated a significant reduction in no-show rates and comparable glycemic control to in-person visits in publicly insured patients with T2D. Telemedicine may be associated with lower no-show rates due to a reduction of socioeconomic barriers compared to in-person visits. Future studies are warranted to further clarify potential associations of specific socioeconomic barriers.
Recommended Citation
Gandhi, Jay, "Telemedicine Slashes ‘No Show’ Rates and Achieves Comparable Outcomes in Diabetes Care" (2023). Yale School of Medicine Physician Associate Program Theses. 197.
https://elischolar.library.yale.edu/ysmpa_theses/197
