Age, Residence Type, and Practice Setting Affect Telehealth Use

August 02, 2023 - A new study found that telehealth use increased between 2019 and 2021. Various patient- and provider-level factors such as age, area of residence, and type of provider practice setting had a significant impact on outcomes. The high level of satisfaction with telehealth also indicates the need for further reimbursement.

Although it wasn’t unavailable, telehealth was significantly less common before the COVID-19 pandemic. At the onset of the public health emergency (PHE), this care modality became highly used due to barriers to in-person care to limit disease exposure.

On top of this, research indicates that patients battling cancer and COVID-19 simultaneously are at risk of negative outcomes. After the declaration of the PHE, cancer centers began using telehealth, a nontraditional care model, to minimize risk.

Curious about factors that affected oncologic telehealth visits, researchers conducted a real-world analysis. This research process examined how patient- and provider-related factors impact telehealth and facility-based visits.

Researchers used multivariable models to explore the operations of a multisite United States cancer practice. They considered three years of data from July to August. In 2019, this comprised 32,537 visits. For 2020 and 2021, there were 33,399 and 35,820 total visits, respectively. 

During these three periods, telehealth use increased from less than 0.01 percent in 2019, to 11 percent in 2020, and 14 percent in 2021. Upon analysis of patient-level factors, researchers noticed various trends. Increased telehealth use was linked to residing in nonrural areas and being 65 years old or younger. Compared to nonrural settings, rural communities had lower video visit use rates and higher phone visit rates.

Trends surrounding provider-level factors also emerged. Regarding practice settings, tertiary and community-based locations contained differences.

Overall, higher telehealth use rates were not correlated with duplicative care. Researchers reached this conclusion after noticing that per-patient and per-physician visit volumes in 2021 were similar to rates from prior to the pandemic.

Given these results, researchers acknowledged that telehealth reimbursement strategies should be considered. This is largely due to the evidence that supports this type of care, along with its expansion that took place without duplication.

Prior research has also indicated the continued rise in telehealth use in 2021.

In September 2021, the FAIR Health Monthly Telehealth Regional Tacker indicated that national telehealth use rose 2.3 percent  However, aside from this increase, COVID-19 did not appear on the list of top five telehealth diagnoses nationally.

Other research has indicated that telehealth produces similar results to in-person care when applied to cancer treatment.

A study from April 2022 found that the use of telehealth for postoperative visits did not raise readmission risks compared to in-person visits after inpatient cancer surgery.

Using data from 535 patients who participated in non-emergency inpatient cancer surgeries, researchers considered unplanned hospital readmissions within 90 days.

When comparing in-person and virtual postoperative visits, there was no difference in 90-day readmission rates.

These research cases indicate that positive effects often emerge with rises in telehealth use, alluding to the sustainability of telehealth.