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<p>Virtual healthcare delivery has become increasingly integrated into type 2 diabetes (T2D) management, but evidence on whether timeliness benefits are equitably distributed is limited. This study aimed to evaluate the impact of virtual versus in-person specialist appointments on timeliness of care for people with T2D and examine equity across demographic groups. We conducted a retrospective cohort analysis of outpatient appointments in Northwest London (January 2021–December 2024). The primary outcome was median referral-to-appointment (RTA) time. Wilcoxon rank-sum tests compared RTA times between virtual and in-person appointments, stratified by patient demographics. Benjamini-Hochberg correction controlled for multiple testing. Temporal trends were examined through year-by-year comparisons. Among 12,474 appointments (90.3% in-person, 9.7% virtual), virtual appointments were associated with 44% shorter median RTA time (20 vs 36 days, p &lt; 0.001). Significant reductions were observed for both genders (males: 18.5 days shorter; females: 17 days), middle-aged and older adults (40-95 years: 15 days; 60-79 years: 22 days), Asian/Asian British patients (26 days), White patients (13 days), and across all deprivation quintiles, including the most deprived (IMD 1: 23 days, 59% reduction) and the least deprived (IMD 5: 26 days, 81% reduction). However, no significant differences were found for young adults (18-39 years), oldest adults (80+ years), Black/Black British, Mixed ethnicity, and other ethnic groups (all p &gt; 0.05). Temporal analysis showed virtual RTA decreased from 35.5 to 8 days (2021-2024), while in-person RTA increased from 28 to 42 days. Virtual appointments were associated with improved timeliness of care for people with T2D overall when compared with in-person visits. However, this observational analysis does not establish causation, and further research (particularly prospective or experimental studies) is needed to confirm these relationships. Notably, important variations emerged across groups, underscoring the need for healthcare organisations to implement equity monitoring to ensure that any benefits are realised across all populations.</p>

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Impact of virtual appointments on referral-to-appointment times for type 2 diabetes patients in Northwest London

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月1日

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  • Reham Aldakhil,
  • Geva Greenfield,
  • Gabriele Kerr,
  • Alex Bottle,
  • Benedict Hayhoe,
  • Holger Kunz,
  • Ana Luisa Neves

摘要

Virtual healthcare delivery has become increasingly integrated into type 2 diabetes (T2D) management, but evidence on whether timeliness benefits are equitably distributed is limited. This study aimed to evaluate the impact of virtual versus in-person specialist appointments on timeliness of care for people with T2D and examine equity across demographic groups. We conducted a retrospective cohort analysis of outpatient appointments in Northwest London (January 2021–December 2024). The primary outcome was median referral-to-appointment (RTA) time. Wilcoxon rank-sum tests compared RTA times between virtual and in-person appointments, stratified by patient demographics. Benjamini-Hochberg correction controlled for multiple testing. Temporal trends were examined through year-by-year comparisons. Among 12,474 appointments (90.3% in-person, 9.7% virtual), virtual appointments were associated with 44% shorter median RTA time (20 vs 36 days, p < 0.001). Significant reductions were observed for both genders (males: 18.5 days shorter; females: 17 days), middle-aged and older adults (40-95 years: 15 days; 60-79 years: 22 days), Asian/Asian British patients (26 days), White patients (13 days), and across all deprivation quintiles, including the most deprived (IMD 1: 23 days, 59% reduction) and the least deprived (IMD 5: 26 days, 81% reduction). However, no significant differences were found for young adults (18-39 years), oldest adults (80+ years), Black/Black British, Mixed ethnicity, and other ethnic groups (all p > 0.05). Temporal analysis showed virtual RTA decreased from 35.5 to 8 days (2021-2024), while in-person RTA increased from 28 to 42 days. Virtual appointments were associated with improved timeliness of care for people with T2D overall when compared with in-person visits. However, this observational analysis does not establish causation, and further research (particularly prospective or experimental studies) is needed to confirm these relationships. Notably, important variations emerged across groups, underscoring the need for healthcare organisations to implement equity monitoring to ensure that any benefits are realised across all populations.