1037-P: Evaluating the Impact of Telemedicine Care Coordination on Access to Care in Oregon’s Pediatric Type 1 Diabetes Population

Abstract

Background: Children with type 1 diabetes (T1D) require close monitoring with visits every 3-4 months. COVID-19-induced telemedicine expansion (TE) may alleviate the challenge of high visit frequency that children with type 1 diabetes (T1D) face. However, telemedicine’s impact on access to care may be limited if patients lack adequate support for telemedicine. Purpose: The study objective was to evaluate the impact of telemedicine care coordination services (CCS) on visit frequency in an urban medical center without CCS versus a rural outreach program with established CCS. Methods: We evaluated EHR data from 790 children receiving care between July 2018 - December 2021. We estimated differences in likelihood of adequately-timed monitoring care (ATMC) over time by patient CCS status using Generalized Estimating Equations. Results: Just prior to TE, patients receiving CCS were 25.6% less likely to receive ATMC (95% CI: 51.6%, 114%). Following TE, likelihood of ATMC increased from 28.8% to 58.2% among those receiving CCS and decreased from 38.7% to 22.0% among those not receiving CCS; increases in ATMC were 3.55 times greater in patients receiving CCS relative to those not (95% CI: 2.10, 6.01). Conclusions: Telemedicine may only increase the number of T1D patients meeting goal visit frequency when paired with CCS. Disclosure E.S.Mitchell: None. S.B.Andrea: Research Support; Eli Lilly and Company. I.Guttmann-bauman: None.