ABSTRACT
This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association (B = −0.339, p < 0.001), suggesting that patients using TM were likely to have 0.34 lower HbA1c % values on average when compared with F2F visits. The regression coefficient for female (vs. male) gender showed a positive association (B = 0.190, p < 0.034), with HbA1c % levels showing that female patients had 0.19 higher HbA1c levels than males. Age (B = −0.026, p < 0.001) was a significant predictor of HbA1c % levels, with 0.026 lower HbA1c % levels for each year's increase in age. Black adults (B = 0.888, p < 0.001), on average, were more likely to have 0.888 higher HbA1c % levels when compared with White adults.
ABSTRACT
This study quantifies the transmission potential of SARS-CoV-2 across public health districts in Georgia, USA, and tests if per capita cumulative case count varies across counties. To estimate the time-varying reproduction number, Rt of SARS-CoV-2 in Georgia and its 18 public health districts, we apply the R package 'EpiEstim' to the time series of historical daily incidence of confirmed cases, 2 March-15 December 2020. The epidemic curve is shifted backward by nine days to account for the incubation period and delay to testing. Linear regression is performed between log10-transformed per capita cumulative case count and log10-transformed population size. We observe Rt fluctuations as state and countywide policies are implemented. Policy changes are associated with increases or decreases at different time points. Rt increases, following the reopening of schools for in-person instruction in August. Evidence suggests that counties with lower population size had a higher per capita cumulative case count on June 15 (slope = -0.10, p = 0.04) and October 15 (slope = -0.05, p = 0.03), but not on August 15 (slope = -0.04, p = 0.09), nor December 15 (slope = -0.02, p = 0.41). We found extensive community transmission of SARS-CoV-2 across all 18 health districts in Georgia with median 7-day-sliding window Rt estimates between 1 and 1.4 after March 2020.