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The financial implications of telemedicine practice patterns across pediatric surgical specialties
Emily S Chwa1, Joshua P Weissman1, Sarah A Applebaum2
1Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Insights
Telemedicine use in pediatric surgery varied by specialty during COVID-19. In-person visits incurred higher charges, but reimbursements were similar for telehealth and in-person encounters.
Area of Science:
- Healthcare Management
- Surgical Informatics
- Public Health
Background:
- The COVID-19 pandemic accelerated telemedicine adoption in surgical care.
- Limited data exists on telemedicine usage and cost correlations across surgical specialties during the pandemic.
Purpose of the Study:
- To analyze telemedicine utilization trends in pediatric surgical specialties.
- To compare the costs and reimbursements of telemedicine versus in-person encounters.
Main Methods:
- Retrospective analysis of telehealth encounters from April 2020 to June 2021 at a pediatric academic institution.
- Calculated the percentage of telemedicine vs. in-person encounters over time.
- Compared average charges and reimbursements between encounter types across specialties.
Main Results:
- Telemedicine constituted 4.5% of 147,007 surgical encounters, peaking in April 2020.
- Neurosurgery (23.2%) and cardiovascular-thoracic surgery (11.9%) showed highest telemedicine use; orthopedics had the lowest (2%).
- In-person visits generally had higher charges, while reimbursements were comparable for both visit types.
Conclusions:
- Telemedicine adoption varied significantly among pediatric surgical specialties during the pandemic.
- Higher charges for in-person visits did not correlate with higher reimbursements compared to telehealth.
- Understanding these trends is crucial for pediatric institutions to manage future telemedicine adoption and policy development.
Background:
Telemedicine has played an increasingly important role in surgical care during the coronavirus disease 2019 (COVID-19) pandemic, yet little is known about its usage and correlation to cost both within and across surgical specialties during the pandemic.
Study Design:
We collected data on telehealth encounters from April 2020 to June 2021 for all surgical specialties at a pediatric academic institution. The percent of total encounters that were telemedicine vs. in-person were analyzed over time. Data on charge and reimbursement were averaged for each encounter type, and the percent difference in average charge and reimbursement was calculated and compared between surgical specialties.
Results:
Of the 147,007 surgical clinical visits identified, 6,566 encounters (4.5%) were telemedicine. Usage peaked in April and plateaued in June of 2020. The specialties with the highest total percentages of telemedicine visits were neurosurgery (23.2%) and cardiovascular-thoracic (11.9%). Orthopedics reported the lowest usage at 2%. Charges for in-person encounters were higher for nearly all specialties while reimbursements remained equal.
Conclusion:
Our institutional trends reveal that conversion to telemedicine varied across surgical specialty during the COVID-19 pandemic. Charges for in-person encounters were higher than telehealth ones for nearly all specialties, but the reimbursements were fairly the same. Understanding trends in telemedicine volume instigated by and following the pandemic may better prepare pediatric institutions to navigate the accelerated adoption and influence policy changes. This is particularly relevant given the fluctuating impact of the pandemic on healthcare institutions as new strains of COVID-19 emerge.
Evidence Level:
Level V.
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