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Area of Science:

  • Neurology
  • Health Services Research
  • Telemedicine

Background:

  • Telemedicine implementation expanded outpatient neurology care options.
  • Uncertainty exists regarding which new neurology patients are suitable for virtual evaluation.
  • This study compared healthcare utilization following virtual versus in-person new patient neurology visits.

Purpose of the Study:

  • To compare subsequent healthcare utilization after virtual versus in-person new patient neurology visits.
  • To assess differences in neurologic clinic follow-up, emergency department (ED) visits, and hospitalizations.
  • To analyze outcomes stratified by neurologic chief complaint and institution.

Main Methods:

  • Retrospective multicenter cohort study of adult new outpatient neurology visits (September 2020 - December 2021).
  • Propensity score matching (1:1) of virtual and in-person patients based on demographics, clinical characteristics, time period, and prior healthcare utilization.
  • Comparison of rates for neurologic clinic follow-up, ED visits, hospitalizations, testing, and all-cause ED visits/hospitalizations within 90 days.

Main Results:

  • After matching, 8,202 virtual visits were compared to 8,202 in-person visits.
  • Neurology follow-up within 90 days did not significantly differ (24.6% vs 23.7%, p=0.18).
  • Neurologic and all-cause ED visits and hospitalizations within 90 days were comparable between virtual and in-person groups.

Conclusions:

  • New neurology patients seen virtually demonstrated similar downstream utilization compared to in-person visits.
  • Comparable 90-day follow-up rates and similar rates of neurologic and all-cause ED visits and hospitalizations were observed.
  • While follow-up varied modestly by chief complaint and testing was more frequent in some in-person visits, overall differences were not significant.