Aims

Healthcare organizations are increasingly using technology to assist in diabetes management based on telemedicine’s proven ability to improve glycemic regulation, decrease cost, and overcome barriers to effective healthcare. Nevertheless, it remains unclear how telemedicine intersects with primary care. We aim to measure the impact of a remote monitoring program for diabetes on primary care delivery through analysis of primary care office visit frequency.

Methods

Patients eligible to participate in our institution’s remote diabetes monitoring program were identified and classified as enrolled or not enrolled (i.e. “usual care”). The number of scheduled and completed primary care office visits in the 12 months prior to and after the index date were measured for both groups. The index date was the enrollment date or, for the patients who received usual care, the next available enrollment session after eligibility screen. Two-sample t-tests were used to examine the change in frequency of office visits prior to and after enrollment for participants, as well as the difference in visit frequency between enrolled patients versus patients receiving usual care.

Results

There was no statistical difference in the number of scheduled or completed primary care clinic visits before or after enrollment in telehealth. Furthermore, there was no difference in the number of scheduled or completed primary care visits between patients enrolled in telehealth versus those receiving usual care.

Conclusion

Participation in telehealth has been shown to be associated with significant HbA1c reductions in prior work, yet our data suggest that remote monitoring is not associated with a change in primary care office visit frequency. This suggests that telehealth may improve diabetes management independently of primary care visits.

中文翻译：

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远程患者监测对成人 2 型糖尿病患者初级保健诊所就诊频率的影响。

宗旨

医疗保健组织越来越多地使用技术来协助糖尿病管理，这是基于远程医疗经过验证的改善血糖调节、降低成本和克服有效医疗保健障碍的能力。然而，目前尚不清楚远程医疗如何与初级保健相结合。我们旨在通过分析初级保健办公室就诊频率来衡量糖尿病远程监测计划对初级保健服务的影响。

方法

有资格参加我们机构的远程糖尿病监测计划的患者被确定并分类为已登记或未登记（即“常规护理”）。测量了两组在索引日期之前和之后的 12 个月内预定和完成的初级保健办公室访问次数。索引日期是登记日期，或者对于接受常规护理的患者，是资格筛选后的下一个可用登记会话。使用双样本 t 检验来检查参与者在登记前后就诊频率的变化，以及登记患者与接受常规护理的患者之间就诊频率的差异。

结果

在加入远程医疗之前或之后，预定或完成的初级保健诊所就诊次数没有统计学差异。此外，参加远程医疗的患者与接受常规护理的患者在预定或完成的初级保健就诊次数上没有差异。

结论

已证明参与远程医疗与先前工作中 HbA1c 的显着降低有关，但我们的数据表明，远程监控与初级保健办公室就诊频率的变化无关。这表明远程医疗可以独立于初级保健就诊来改善糖尿病管理。