1. Care Continuity, Telehealth Use, and Quality of Diabetes and Hypertension Care in Community Health Centers Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study
- Author
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Tierney, Aaron Alexander, Payán, Denise D, Brown, Timothy, Aguilera, Adrian, Shortell, Stephen M, and Rodriguez, Hector P
- Subjects
Cardiovascular ,Prevention ,Hypertension ,Health Services ,Clinical Research ,Networking and Information Technology R&D (NITRD) ,Diabetes ,7.1 Individual care needs ,Management of diseases and conditions ,Good Health and Well Being - Abstract
Background: Community health centers (CHCs) pivoted to remote chronic care services during the COVID-19 pandemic. While care continuity is associated with improved care quality and patients’ experiences, telehealth’s impact on these relationships is unclear. Objective: We aimed to examine the association among care continuity, telehealth use, and quality of diabetes or hypertension care in CHCs before and during the COVID-19 pandemic. Methods: We collected electronic health record data from a cohort of 20,792 patients with diabetes or hypertension with ≥2 visits per year from March to December 2019 and 2020 among 166 California CHCs in the OCHIN Accelerating Data Value Across a National Community Health Center Network Collaborative. Logistic regression models estimated the association between care continuity (modified, modified continuity index [MMCI]) and telehealth adoption and blood pressure or hemoglobin A1c (HbA1c) testing. Generalized linear regression models for 2019 and 2020 estimated the association between MMCI and blood pressure or HbA1c, exploring telehealth as a mediator. Results: Patients experienced reduced care continuity (2019: MMCI=0.71, SD 0.28; 2020: MMCI=0.63, SD 0.36; P
- Published
- 2023