ประสิทธิผลของการพัฒนาระบบการแพทย์ทางไกล ในการดูแลผู้ป่วยเบาหวานชนิดที่ 2 เครือข่ายหน่วยบริการปฐมภูมิ พื้นที่เกาะ

Siranut Nawong

Authors

Siranut Nawong -

Keywords:

telemedicine, type 2 diabetes, glycemic outcome, primary care, health equity

Abstract

This survey research by retrospective cohort study aimed to evaluate the effectiveness of telemedicine (synchronous video conference via application) on glycemic control in 116 patients with type 2 diabetes in a primary care setting in the island region compared with in-person care in a secondary care hospital. HbA1c, FPG level, blood pressure, and serum lipid profile was assessed periodically after 36 months of follow-up. The patient satisfaction questionnaire and the patient costs (including time, travel costs, and opportunity costs) were also examined. Data were analyzed using analytical statistics, including percentages and an independent t-test.

The results at 36 months of follow-up indicated that telemedicine was superior to in-person care in improving HbA1c levels, with a mean difference (MD) of -0.65, p < 0.001. Mean HbA1c reduced from 8.21 ± 0.96% to 7.13 ± 0.84% (p < 0.001) in the telemedicine group; patients also showed a statistically significant reduction (p < 0.001) in FPG and LDL. The proportion of good glycemic control (HbA1c ≤ 7.0) was 42.10% in the study group and 28.57% in the control group. Patients with telemedicine visits had lower odds of uncontrolled diabetes compared to in-person care (OR: 0.81; 95% CI: 0.45–1.46). Patients reported a high level of satisfaction and acceptance of telemedicine. (x̄ = 4.91, SD = 0.28). Telemedicine reduced direct and indirect patient costs for patients in remote areas by 542.16 Baht per visit compared to an in-person visit.

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