Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity.
David Y Ming, Tingxuan Li, Melissa H Ross and 8 others
PMID 34879986WHAT IT FOUND
Post-discharge weekly video visits for children with medical complexity were feasible and acceptable.
Hospital use fell in both the video-visit and usual-care groups. The visits were not shown to reduce admissions.
Key findings
01Post-discharge video visits were feasible: 75% of scheduled visits were completed, and half connected within 1 minute.
02Parents found the visits acceptable and reported mean savings of $77.19 per visit for travel compared with in-person visits.
03Hospital use fell after discharge in both groups, and caregiver self-efficacy and family self-management did not differ significantly between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 42 individual patients participated, and recruitment stopped before the target of 35 intervention patients because of the pandemic. Most eligible families were not reached before discharge (86.6%), and 32% of intervention parents withdrew. The study was non-randomized, and six patients were counted in both control and intervention periods. The intervention group was already receiving longitudinal complex care, and hospital use fell in both groups. Families without home internet, portal access, or a personal device were excluded.
Declared interests
One author reported research grants from Otsuka, Novo Nordisk, Sanofi, Improved Patient Outcomes, Boehringer Ingelheim, NIH, and VA, and consulting from Sanofi, Novartis, Otsuka, Abbott, Xcenda, Preventric Diagnostics, and the Medicines Company; all other authors declared no relevant financial relationships.
The easy way to misread this
Do not read the significant drop in hospitalization rate in the video group as proof that video visits caused fewer admissions. The control group also had significant reductions. The groups were not randomized. The intervention group was already receiving longitudinal complex care. The effect of video visits alone cannot be separated.