University of Pennsylvania researchers saw telehealth use after hospital discharges increases while outpatient visit frequency remained unchanged.
The research team examined FAIR Health claims data from January 2019 to December 2020. Of 70 million commercially insured and Medicare Advantage enrollees, they identified 1.6 million hospital discharges of patients (≥ 50 years). They determined who had evaluation and management visits with a primary care, medical subspecialty, or surgical speciality clinician within the 30 days after discharge. Outpatient visits included both in-person and telehealth visits. Care access was determined by calculating the per cent of discharges with one or more visits within 30 days. The mean number of visits per discharge within 30 days determined care utilisation.
From April 2019 to April 2020, discharges with in-person visits fell from 72% to 55%, whereas those with telehealth visits rose from 0% to 46%. Outpatient visits per discharge (in-person and telehealth) marginally rose from 72% to 75% in May 2020. Care utilisation rose from 2.98 in April 2019 to 3.40 in April 2020 but then fell toward baseline. Average in-person visits fell from 2.94 in 2019 to 2.35 in 2020, a decrease of 0.6 (20%). The difference consisted of telehealth visits growing from 0.02 in 2019 to 0.7 in 2020, an increase of 0.7 — a 35 fold increase.
Although the average frequency of outpatient visits after discharge remained level, telehealth visits appeared to substitute for in-person visits. Prepandemic, telehealth supplemented in-person care for specific clinical conditions. As the pandemic caused deferral of discretionary care, telehealth compensated. Since postdischarge follow-up care is unlikely to be discretionary, telehealth is convenient for recovering patients. While overall postdischarge care utilization has remained the same, nearly 30% have continued to use telemedicine
Source: JAMA Health Forum
