A Retrospective Analysis of Clinical Utilization Between Patients Who Used Telemedicine and Office Visits in Outpatient Physical Medicine and Rehabilitation Clinics During the COVID-19 Pandemic.
Gabrielle Gilmer, Natalie Jackson, Stephen Koscumb and 2 others
PMID 35302527WHAT IT FOUND
Telemedicine patients had more follow-up visits and higher opioid use, but no difference in emergency care.
Sicker patients and people of color used telemedicine more. This reflects pandemic-era selection bias, not proof that video visits are safer or more efficient.
Key findings
01Patients seen only via telemedicine had significantly more follow-up visits than those seen only in the office.
02There were no significant differences in emergency department or urgent care visits between telemedicine and office visit groups.
03The telemedicine group had significantly more bedded hospitalizations at 30 days post-appointment compared to the office visit group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was a retrospective look at data from the height of the pandemic, so patient behavior and clinic rules were unusual and may not apply to normal times. The groups were not alike: telemedicine patients were sicker and more likely to be people of color, which skews the results. The researchers could not tell if prescriptions were new or if the patient had been taking them for years. The database only captured care within one hospital network, so visits to outside emergency rooms were missed. The study could not adjust for confounding variables like age or disease severity because too few patients had emergency events.
Declared interests
The study was supported by the National Institutes of Health. No other conflicts of interest were reported.
The easy way to misread this
Do not conclude that telemedicine causes more hospitalizations or opioid use. The telemedicine group was already sicker and had more chronic conditions than the office group, and the study could not control for these differences.