Telehealth Utilization and Follow-Up Visits in Developmental-Behavioral Pediatrics During the COVID-19 Pandemic in 2020
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Asher Ripp1, Caren Steinway1,2, Michelle Weiss Katzow1,2,3
1Division of General Pediatrics, Department of Pediatrics, Cohen Children's Medical Center of NY, New Hyde Park, NY.
Insights
Telehealth visits significantly increased follow-up appointment attendance in developmental-behavioral pediatric (DBP) care compared to in-person visits. This finding suggests telehealth improves patient adherence in DBP practices.
Area of Science:
- Pediatrics
- Health Services Research
- Digital Health
Background:
- Developmental-Behavioral Pediatric (DBP) practices often face challenges with patient follow-up visit attendance.
- The COVID-19 pandemic necessitated a rapid shift from in-person to telehealth care models.
Purpose of the Study:
- To evaluate the impact of the transition to telehealth on follow-up visit attendance in a DBP practice.
- To compare visit adherence rates between telehealth visits in 2020 and in-person visits in 2019.
Main Methods:
- A retrospective observational cohort study design was employed.
- Data from a 6-week period in March/April 2019 (in-person) and 2020 (telehealth) were analyzed.
- Logistic regression was used to compare follow-up visit adherence, adjusting for patient demographics and clinical characteristics.
Main Results:
- The study included 2142 visits for 1868 patients.
- Telehealth visits showed higher completion rates (75.3%) compared to in-person visits (64.4%).
- Adjusted analysis revealed a significantly higher likelihood of visit completion for telehealth compared to in-person visits (OR=1.57, p<0.001).
Conclusions:
- Telehealth care is associated with increased follow-up visit attendance in developmental-behavioral pediatric settings.
- The findings suggest telehealth can be an effective modality for improving patient adherence in DBP care.
- Further research is warranted to explore the long-term impact of telehealth on clinical outcomes in chronic disease management within DBP.
Objective:
The goal of this study was to understand the effect of transition to telehealth care on follow-up visit attendance in a developmental-behavioral pediatric (DBP) practice in 2020 versus in-person care in 2019.
Methods:
This was a retrospective observational cohort study of follow-up visits occurring in a large DBP practice during a 6-week period in March/April of 2019 and 2020. The primary outcome was follow-up visit adherence, defined as completion of scheduled follow-up visit. The primary exposure was telehealth visit in 2020 versus in-person visit in 2019. Covariates included patient demographics and clinical characteristics. Data were analyzed using descriptive statistics and logistic regression.
Results:
The cohort included 2142 visits for 1868 unique patients. The patient mean age was 9.2 ± 4.8 years, with 73.4% male, 56.5% non-Hispanic, 51.4% White, and 68.3% commercial insurance. There were 470 telehealth visits from March to April 2020 and 1672 in-person visits from March to April 2019. Compared with in-person visits, telehealth visits were more likely to be completed (75.3% vs 64.4%, p < 0.001). After adjusting for age, sex, race, ethnicity, insurance, and week of visit (weeks 1-3 vs 4-6), odds of having a complete follow-up visit were higher for telehealth visits than for in-person visits (odds ratio = 1.57; 95% confidence interval [1.23-2.00], p < 0.001).
Conclusion:
Follow-up visit attendance was higher for telehealth care in 2020 than in-person care in 2019. This association persisted after adjusting for insurance, age, race, and ethnicity, suggesting that telehealth is associated with increased follow-up visit attendance in DBP care. Further studies are needed to understand the impact of telehealth on DBP clinical outcomes in chronic disease management.
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