Telehealth More Likely to Prompt Follow-up for Acute Conditions
New research shows that telehealth appointments for acute conditions were more likely than in-person appointments to result in a follow-up visit.
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By - While researching the correlation between visit type and chances of a follow-up appointment, a study published in JAMA Network Open found that telehealth appointments for acute conditions resulted in a higher likelihood of multiple follow-up visits than in-person appointments.
The cohort study consisted of 40 million patients and evaluated their activity between 2019 and 2020.
Within these two years, the COVID-19 pandemic sharply increased the percentage of telehealth encounters as a proportion of all ambulatory encounters, from 0.6 percent in 2019 to 14.1 percent in 2020. The use of telehealth remained high following even after COVID-19 cases began to decline.
Researchers examined the follow-up activity that took place 14 days after the initial virtual or in-person encounters.
They observed that generally acute care patients who had an initial visit conducted through telehealth were more likely to participate in a follow-up appointment than those who initially received care in person.
For example, for acute bronchitis, 23.3 percent of the first encounter appointments took place through telehealth. The odds ratio of a follow-up encounter following that first virtual encounter was 1.23 as compared to 1 for those who had an in-person visit.
Similarly, for acute pharyngitis, the odds ratio of a follow-up encounter was 1.46 after a telehealth visit, higher than the odds ratio of following an in-person visit.
On the other hand, an initial telehealth visit for chronic conditions resulted in similar rates of follow-up as compared to initial in-person encounters for these conditions.
These findings can provide researchers with an idea of how to proceed with the implementation of telehealth and how best to use it to enhance different types of care.
As for study limitations, researchers noted that there could be existing bias regarding how a patient received a recommendation for a care setting. The use of medication and lab tests also could have skewed results, along with the time limit of 14 days and the lack of inclusion of Medicare, Medicaid, and uninsured patients.
As health systems experiment with implementing hybrid models of care, other studies have compared telehealth and in-person visits for various conditions.
For example, a study published in March found that heart failure readmissions were similar after telehealth and in-person follow-up appointments. Specifically, researchers found that telemedicine reduced 30-day readmission rates at a similar rate to in-person care.
Another study from earlier this month found that readmission rates among cancer patients were similar following in-person and virtual postoperative visits. They also found no differences in 90-day mortality and length of stay during readmission between in-person and virtual postoperative visits.
Telehealth can also increase care access. A recent study shows that spine patients missed 51.3 percent of in-person appointments and 24.7 percent of telemedicine appointments, indicating that telehealth provides a relatively high level of satisfaction and accessibility.
