Telemedicine Decreases No-Show Rates and Achieves Comparable Outcomes in Publicly Insured Patients With Type 2...

Patients with type 2 diabetes (T2D) require continuous management to achieve optimal outcomes. Socioeconomic barriers can impede the delivery of optimal diabetes care. During the COVID-19 pandemic, telemedicine likely reduced common barriers to care compared with in-person visits. This study investigated the impact of telemedicine on no-show rates and diabetes outcomes in publicly insured patients and the potential link to reduced socioeconomic barriers.

This retrospective study analyzed the records of 819 patients with T2D at the Yale Medicine Diabetes Center (YMDC). From June 2019 to March 2020, patients had in-person clinic visits, followed by telehealth visits from March to December 2020 due to system-wide COVID-19 isolation mandates. No-show rates, glycemic control metrics, and other biomarkers were compared in the same patients between their in-person and telehealth visit periods.

Patients utilizing telemedicine averaged no-show rates of 0.34 ± 0.69 compared with 1.19 ± 1.30 (P < .001) for in-person visits. Average hemoglobin A1c (HbA1c) for telemedicine was 7.93 ± 1.95 compared with 7.91 ± 1.90 (P = .65) for in-person visits. Percentages of patients achieving ≥70% glucose time in range (TIR) on an ambulatory glucose profile (AGP) was 43.90% for telehealth and 45.42% (P = .76) for in-person visits.

Publicly insured patients with T2D showed significantly reduced no-show rates and comparable glycemic control during telemedicine visits compared with in-person visits. Telemedicine visits may be associated with lower no-show rates due to a reduction of socioeconomic barriers. Future studies are warranted to further clarify potential associations of specific socioeconomic barriers to missed visits.