E-Visit Usage Among a Population of Young Adults

Asynchronous electronic visits (e-visits) and telehealth may provide comparable health outcomes to in-person care in line with the implementation of value-based care.

Study population was newly enrolled individuals (ages 18-26) in an integrated health plan in 2023 (N = 30,099). In this cross-sectional study, multivariate analyses focused on covariates associated with e-visit utilization. The association of emergent and discharge status with urinary tract infection (UTI) e-visit usage was examined in the subset of emergency department (ED) visits for female patients with UTI (n = 258).

During the first 18 months of membership, the newly enrolled 18- to 26-year-olds completed 22,483 e-visits. Needing a translator, using Medicare/Medicaid, and residing in areas with higher neighborhood deprivation indices were associated with a reduced likelihood of using e-visits. Having a chronic problem or identification of a primary care practitioner within 3 months were associated with increased likelihood of using an e-visit. In the ED subset, an association was seen between Hispanic identity and decreased likelihood of e-visit usage. A total of 2537 (11 %) of all e-visits were for UTI, and 258 (3%) of all ED visits were for UTI. Of the 258 ED visits for UTI, 95% were discharged home.

Most UTI-related ED visits were deemed not emergent and resulted in discharge home, which suggests room for improvement in delivery of value-based care. This could be achieved by increasing access to e-visits for individuals living in deprived neighborhoods, needing a translator, having Medicare/Medicaid, and identifying as Hispanic.

Promotion of e-visit utilization among new young adult members could improve value-based health care utilization and maintain clinical outcomes.