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Healthcare Utilization Differences Among Primary Care Patients Using Telemedicine in the Veterans Health
Amy M J O'Shea1,2,3, Kailey Mulligan4,5, Paige Carlson6
1VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA. amy.oshea@va.gov.
Journal of General Internal Medicine
|January 22, 2024
Summary
Telemedicine use, especially video, was linked to increased healthcare utilization after primary care visits compared to in-person only care. Further research is needed to understand these differences.
Area of Science:
- Health Services Research
- Telemedicine
- Primary Care
Background:
- The COVID-19 pandemic accelerated telemedicine adoption.
- Limited research exists on telemedicine's impact on follow-up healthcare utilization in primary care.
Purpose of the Study:
- To compare healthcare utilization patterns among primary care patients utilizing different forms of telemedicine.
- To evaluate differences in follow-up care utilization based on telemedicine modality.
Main Methods:
- Retrospective observational cohort study of US veterans using administrative data.
- Categorized telemedicine exposure: in-person only, telephone, or video visits.
- Compared healthcare utilization within 7 days post-primary care visit, adjusting for patient and area factors.
Main Results:
- Over 3.4 million veterans and 12.9 million primary care visits were analyzed.
- Video telemedicine users showed higher rates of emergent care and inpatient admissions compared to in-person only users.
- Adjusted analyses revealed increased odds of emergent care, inpatient admissions, and ambulatory care sensitive condition admissions for video telemedicine users.
Conclusions:
- Telemedicine, particularly video, may be associated with higher follow-up healthcare utilization than in-person primary care.
- Factors driving these utilization differences between telemedicine modalities require further investigation.
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