Decreased Health Care Utilization in Complex Care Pediatrics After 1 Year with a Remote Examination Device

Background: Children with medical complexity are a growing population of pediatric patients with high health care utilization. Telemedicine could provide timely and reliable access to care that mitigates the associated burden of transportation and cost of expensive emergency room visits or hospitalizations. This study evaluated the health care utilization of patients in a complex care center (CCC) after a year with a remote examination telehealth device. Methods: A single-center, nonrandomized retrospective observational study was performed. The health care utilization of 273 patients with the device (cases) was evaluated 1 year after device acquisition and compared with health care utilization 2 years and 1 year prior to device acquisition. The health care utilization of 204 patients without the device (controls) was compared with cases over the same time period. Demographic differences between cases and controls were also evaluated. Results: Cases had significantly less health care utilization compared with controls in the year after device acquisition and compared with the time prior to device acquisition (p < 0.001). Cases were more likely to reside in communities with high socioeconomic status, were more likely to be white, and more likely to speak English than nonusers. Conclusions: A telemedicine remote examination device was shown to be associated with decreased health care utilization in patients in a CCC. However, significant socioeconomic and demographic differences existed between the groups, which may have contributed to these findings.