Acute Care Use and Mortality by Tele-Emergency Care Use, Modality, and Clinician Type

Area of Science:

• Health Services Research
• Telehealth
• Emergency Medicine

Background:

• Tele-emergency care shows promise for assessing acute patient concerns remotely.
• Large-scale evaluations and implementation details for tele-emergency care are lacking.

Purpose of the Study:

• To examine the association between tele-emergency care receipt, modality, and clinician type with patient outcomes.
• To evaluate the impact of tele-emergency care on emergency department visits, hospitalizations, and mortality.

Main Methods:

• A national, multicenter cohort study of veterans calling a nurse advice line (January 2018-April 2024).
• Compared tele-emergency care recipients with usual care using propensity score weighting.
• Analyzed outcomes including emergency department visits, hospitalizations within 7 days, and 30-day mortality.

Main Results:

• Tele-emergency care receipt was associated with a 16.5% lower probability of 7-day emergency department visits compared to usual care.
• Significant reductions in emergency department visits were observed for emergent calls (-22.0%) versus urgent calls (-5.6%).
• No significant differences in 7-day hospitalization or 30-day mortality were found; modality and clinician type showed minimal impact.

Conclusions:

• Tele-emergency care is associated with reduced emergency department utilization, particularly for higher-acuity cases.
• Implementation of tele-emergency care can help health systems manage crowding and address acute care needs effectively.
• Further research into facility-level impacts and broader implementation strategies is warranted.