Evaluation of the Medical Utilization of the Telemedicine Pilot Project for Patients With Diabetes Based on Korean National Health Insurance Claims Data

Background: Numerous studies have explored blood sugar management in patients with diabetes through telemedicine.However, since the implementation of the telemedicine pilot project, no studies have assessed changes in healthcare utilization for diabetes.This study examined medical outcomes and utilization among diabetes patients comparing telemedicine to traditional in-person care, focusing on medical utilization, care continuity, prescription adherence, and safety.Methods: This study used data from the National Health Insurance Service to identify patients with diabetes who did or did not receive telemedicine.We analyzed medical utilization, medical sustainability, prescription continuity, and safety through propensity score matching (PSM).To evaluate the telemedicine pilot project's impact, changes and differences in outcome indicators were calculated using a Difference-in-Differences (DID) approach.Results: After PSM, the total number of patients in the telemedicine group (Tele_G) and the face-to-face treatment group (Control_G) was 59,954 each.Medical utilization of telemedicine decreased in both groups, but the DID was 0.16 (-0.04 in Tele_G vs. -0.20 in Control_G, P < 0.001).Medical continuity also differed significantly between the Tele_G and Control_G (all P < 0.001).The DIDs for the ratio of diabetes medication prescription days and appropriate prescription continuation rate were 0.95 (-0.72 vs. -1.67,P < 0.001) and 1.26 (-1.80 vs. -3.07,P < 0.001), respectively, with statistically significant differences.There were no significant differences in hospitalization experience for safety assessment (DID = -0.14,P = 0.139) or emergency room visits (DID = 0.00, P = 0.950).Conclusion: DID analysis revealed the potential of the telemedicine pilot project, with slightly lower continuity than face-to-face care; hence, it is acceptable as a supplementary service.To improve this, a telemedicine system specializing in diabetes and blood glucose management is needed, along with a clear protocol that allows patient blood glucose data to be integrated into the telemedicine platform.