Compliance of Tonsillitis e-Health Patients: A Prospective Cohort Study

As canceled appointments and undertreated patients generate substantial expenses in healthcare, this study examines whether tonsillectomy candidates assessed via telemedicine-assisted care paths exhibit elevated appointment cancellation rates compared to those evaluated in-person at an outpatient clinic.

At Helsinki University Hospital, a tertiary referral clinic, two telehealth-assisted care paths (virtual visits and a digital care pathway) have been available in recent years to remotely assess patients for tonsillectomy. To evaluate whether preoperative telehealth negatively affects tonsillitis patients' compliance to treatment, we compared cancellation rates of these two e-health care paths as primary outcome measures with the outpatient clinic, which was defined as the control group.

The remote care paths showed the highest rates of cancellation. 25.9% of the digital care pathway patients canceled their care path compared to 6.6% of outpatient clinic patients who canceled appointments (p < 0.01). 29.4% of the digital care pathway patients had an additional remote contact with the clinic preoperatively compared to 18.5% of patients assessed at the outpatient clinic (p = 0.002). Patients assessed remotely were more likely to make an unplanned additional contact than patients seen at the outpatient clinic. No significant differences in canceled surgeries were observed between the cohorts.

Assessing patients for tonsillectomy via a digital care pathway appears to increase cancellations and additional contacts. Therefore, both digital and in-person assessments should remain available for tonsillectomy candidates to accommodate varying patient needs and offset additional costs.

Level 3.