Follow-up visits higher after telemedicine vs in-person consultation

Face-to-face return visits tend to be more frequent following telemedicine than after in-person primary care visits, a study has shown.

Administrative and electronic health record (HER) data were obtained for this retrospective study, which compared treatment and follow-up visits between primary care video or telephone telemedicine and in-person office visits.

A total of 1,589,014 adult patients were included. Of these, 26.5 percent were aged ≥65 years, 54.9 percent were female, 22.2 percent were Asian, 21.5 percent lived in neighbourhoods with lower socioeconomic status, and 31.8 percent had a chronic health condition.

The authors assessed treatment outcomes, such as medication or antibiotic prescribing and laboratory or imaging ordering, as well as follow-up visits, including in-person visits to the primary care office or EM or hospitalization within 7 days.

These outcomes were adjusted for sociodemographic and clinical characteristics overall and stratified by clinical area (ie, abdominal pain, gastrointestinal concerns, back pain, dermatological concerns, musculoskeletal pain, routine care, hypertension or diabetes, and mental health).

Overall, 2,357,598 primary care visits were recorded, of which half used telemedicine (50.8 percent: 19.5 percent video and 31.3 percent telephone). After adjustment, medications were prescribed in 46.8 percent of office visits, 38.4 percent of video visits, and 34.6 percent of telephone visits.

After the initial visits, in-person primary care return visits within 7 days occurred in 1.3 percent of in-person visits, 6.2 percent of video visits, and 7.6 percent of telephone visits. In addition, visits to an emergency department occurred in 1.6 percent of in-person visits, 1.8 percent of video visits, and 2.1 percent of telephone visits.

“Differences in follow-up office visits were largest after index office versus telephone visits for acute pain conditions and smallest for mental health,” the authors said.