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Decreased Health Care Utilization in Complex Care Pediatrics After 1 Year with a Remote Examination Device
Anna Jane Sibilia1,2,3, Scott R Callahan1,2,4, Kathleen Pulda2,5
1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Insights
Telemedicine remote examination devices reduced healthcare utilization in children with medical complexity. Further research is needed to address socioeconomic and demographic disparities observed between users and non-users.
Area of Science:
- Pediatrics
- Health Services Research
- Medical Technology
Background:
- Children with medical complexity represent a growing patient group with high healthcare demands.
- Telemedicine offers potential solutions for accessible, timely care, reducing transportation burdens and emergency room visits.
- This study investigates the impact of remote examination telehealth devices on healthcare utilization in a pediatric complex care center.
Purpose of the Study:
- To evaluate the effect of a remote examination telehealth device on healthcare utilization in pediatric patients with medical complexity.
- To compare healthcare utilization between patients with and without the telehealth device.
- To identify demographic and socioeconomic factors influencing device adoption and outcomes.
Main Methods:
- A single-center, nonrandomized retrospective observational study.
- Compared healthcare utilization 1 year post-device acquisition with 2 years and 1 year prior for 273 patients (cases).
- Compared cases with 204 control patients without the device over similar timeframes, analyzing demographic differences.
Main Results:
- Patients using the remote examination device showed significantly decreased healthcare utilization compared to controls and their own pre-device usage (p < 0.001).
- Device users were more likely to be white, speak English, and reside in higher socioeconomic status communities.
- Significant socioeconomic and demographic differences were noted between device users and non-users.
Conclusions:
- Telemedicine remote examination devices are associated with reduced healthcare utilization in children with medical complexity.
- Observed disparities in socioeconomic status and demographics between user and non-user groups may influence these findings.
- Further investigation is warranted to understand and mitigate potential biases related to socioeconomic and demographic factors in telehealth adoption and outcomes.
Abstract:
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.
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