Primary Care Health Care Use for Patients With Type 2 Diabetes During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic may have delayed care for chronic disease (1). We sought to examine factors associated with total and virtual health care use for primary care visits for patients with type 2 diabetes (T2D) during the pandemic. Using our electronic medical record, we identified patients in the Cleveland Clinic Health System with a diagnosis of T2D with a prepandemic primary care visit between 1 August 2019 and 14 March 2020 (period 0), with follow-up data collected during two pandemic periods: period 1, from 15 March 2020 to 30 June 2020, when in-person visits were rapidly converted to virtual (telephone or video); and period 2, from 1 July 2020 to 15 November 2020, when in-person visits resumed. We obtained demographic characteristics including age, sex, race, insurance type, median income estimated by zip code based on the American Community Survey 2014–2018 5-year estimates (2), and baseline glycosylated hemoglobin (HbA1c). Patient characteristics were summarized with appropriate descriptive statistics. We assessed factors associated with completing any follow-up visits using logistic regression and then assessed factors associated with completing virtual visits using a mixed-effects logistic regression model with a random intercept at the patient level. All statistical analyses were performed in R (cran.r-project.org), and statistical significance was established at two-sided P values <0.05. There were 76,015 patients with T2D …