Acute illness care patterns change with use of telemedicine

Area of Science:

• Pediatric Healthcare
• Telemedicine Utilization
• Health Services Research

Background:

• Health-e-Access is a telemedicine service offering care for acute childhood illnesses.
• The service has conducted over 6500 visits across 10 primary care practices and 22 child care/school sites.
• Previous hypotheses suggested improved access and reduced emergency department (ED) visits and costs.

Purpose of the Study:

• To evaluate the impact of the Health-e-Access telemedicine service on healthcare utilization and costs.
• To test if children using telemedicine had more acute care visits but fewer ED visits and lower overall expenditures.
• To assess the cost-effectiveness of telemedicine in pediatric primary care.

Main Methods:

• A case study compared insurance claims data for children with and without telemedicine access.
• Utilisation of telemedicine, office, and ED care was analyzed for children with at least six months of insurance coverage.
• 19,652 child-months of data from 1216 children with telemedicine access were matched to controls based on age, gender, socioeconomic status, and season.

Main Results:

• Overall illness-related healthcare utilization was 23.5% higher for children with telemedicine access.
• Emergency department (ED) utilization was 22.2% lower in children utilizing the telemedicine service.
• The average age of utilization was 6.71 years, with 79% of cases covered by Medicaid managed care.

Conclusions:

• The Health-e-Access telemedicine model demonstrates potential for reducing healthcare costs.
• Cost savings are primarily achieved by replacing nonemergency emergency department (ED) visits.
• Telemedicine offers a viable alternative for managing acute childhood illnesses, improving access and potentially lowering expenditure.