Comparison of Video-Based Primary Care by Rurality for Chronic Health Conditions at the Veterans Health...

Area of Science:

• Health Services Research
• Telemedicine
• Rural Health

Background:

• Chronic conditions require frequent management, posing challenges in rural areas with limited healthcare access.
• Video-based care offers a potential solution to improve healthcare accessibility.

Purpose of the Study:

• To identify chronic conditions frequently managed via video visits within the Veterans Health Administration (VHA).
• To examine the utilization of video modality for primary care visits based on patient rurality.

Main Methods:

• A nationwide retrospective study analyzing VHA electronic health records from 2023.
• Multivariable logistic regressions assessed the association between video visit use and primary diagnosis, adjusting for patient characteristics and clustering.
• Examined the interaction between patient residence rurality and diagnosis on video visit utilization.

Main Results:

• Over 18.8 million primary care visits were analyzed, with video visits comprising 3.9% (744,865 visits).
• Hypertension, diabetes, musculoskeletal pain, and hyperlipidemia were the most common diagnoses managed via video visits.
• Patients in urban areas were more likely to use video-based care for these chronic conditions compared to rural patients.

Conclusions:

• Video-based care for chronic conditions is less prevalent in rural areas compared to urban settings within the VHA.
• Future research should focus on strategies to improve video-based care access for rural veterans, particularly for chronic care management.