Telehealth service use and quality of care among US adults with diabetes: A cross-sectional study of the 2022 health information national trends survey

BMJ Open. 2024 Nov 3;14(10):e086418. doi: 10.1136/bmjopen-2024-086418.

ABSTRACT

OBJECTIVE: To characterise telehealth use, reasons for using or not using telehealth and the factors associated with telehealth use among US adults with diabetes.

DESIGN: A cross-sectional study.

SETTING: Data were sourced from the 2022 Health Information National Trends Survey.

PARTICIPANTS: US adults aged 18 years or older with self-reported diagnosis of diabetes (both type 1 and type 2).

PRIMARY AND SECONDARY OUTCOMES: Past 12-month utilisation of telehealth services, modality (eg, video, voice only), overall perception of quality of care, perceived trust in healthcare system and patient-centred communication score.

RESULTS: In an analysis of 1116 US adults with diabetes, representing 33.6 million individuals, 48.1% reported telehealth use in the past year. Telehealth users were likely to be younger, women, with higher income, and urban dwellers. Older adults (≥65 years) were less likely to use telehealth compared with those aged 18-49 years (OR 0.43, 95% CI 0.20 to 0.90). Higher income and more frequent healthcare visits were predictors of telehealth usage, with no significant differences across race, education or location. Across respondents with telehealth usage, 39.3% reported having video-only, 35.0% having phone (voice)-only and 25.7% having both modalities. The main motivations included provider recommendation, convenience, COVID-19 avoidance and guidance on in-person care needs. Non-users cited preferences for in-person visits, privacy concerns and technology challenges. Patient-reported quality-of-care outcomes were comparable between telehealth users and non-users, with no significant differences observed by telehealth modality or area of residence (metro status).

CONCLUSIONS: Around half of US adults with diabetes used telehealth services in the past year. Patient-reported care quality was similar for telehealth and in-person visits. However, further efforts are needed to address key barriers to telehealth adoption, including privacy concern, technology difficulties, and care coordination issues.

PMID:39489536 | DOI:10.1136/bmjopen-2024-086418