Clinical and Demographic Attributes of Patients with Diabetes Associated with the Utilization of Telemedicine in an Urban Medically Underserved Population Area

Abstract

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January 2019 to 30 June 2021 of 265 patients with T2DM who had 3357 healthcare appointments. The overall percentage of healthcare provider appointments using TM was 46.7%, in comparison with 53.3% traditional F2F visits. Compared to patients with prediabetes, those with uncontrolled diabetes were more likely to utilize the TM mode of care rather than the traditional F2F mode (adjusted odds ratio (AoR), 1.33; confidence interval (CI), 1.07 to 1.64) after controlling for the other covariates in the model. Compared to patients in the age group 20–49 years, those in the age groups 50–64 years and ≥65 years had significantly lower odds (AoR, 0.78; CI, 0.65 to 0.94 and AoR, 0.71; CI, 0.58 to 0.88, respectively) of utilization of TM than the traditional F2F mode of care. White patients had significantly higher odds of using telemedicine rather than the traditional F2F mode (AoR, 1.25; CI, 1.07 to 1.47) when compared to the Black patients. Gender differences did not exist in the care utilization mode. As healthcare and public health continue to strive for health equity by eliminating health disparities within marginalized populations, it is essential that the mode of care for patients, such as those with T2DM, must evolve and adapt to the needs and resources of the patients. Multisectoral partners have the opportunity to employ a systems thinking approach to improve the technological elements related to the global health disparities crisis. An essential goal is to to create a user-friendly interface that prioritizes easy navigation, affordability, and accessiblity for populations in medically underserved regions to improve overall population health outcomes.