Infectious Disease

Telemedicine was utilized in 30.1% of visits through the COVID-19 pandemic

February 01, 2021

2 min read

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Disclosure:
The study was supported by the National Institute on Aging, the National Institute of Mental Health, and the NIH.

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Telemedicine visits accounted for approximately 30% of all outpatient visits at the onset of the COVID-19 pandemic, with uptake varying according to specialty and patient characteristics. This is evident from research published in Health Affairs.

“In response to the 2019 coronavirus disease (COVID-19) pandemic, the use of telemedicine increased dramatically within a few weeks.” Sadiq Y. Patel, PhD, Postdoctoral fellow at the National Institute of Mental Health in the Health Policy Department at Harvard Medical School, and colleagues wrote. “After years of slow adoption, many clinicians first used telemedicine to limit patient and staff exposure to the virus.”

Telemedicine visits accounted for approximately 30% of all outpatient visits at the onset of the COVID-19 pandemic, with uptake varying according to specialty and patient characteristics. This is evident from research published in Health Affairs. Source: Adobe Stock.

Patel and colleagues evaluated data from 16.7 million people with commercial or Medicare Advantage insurance to assess trends in telemedicine and in-person visits from January 1, 2020 to June 16, 2020. They assessed whether these visits were different depending on patient characteristics, specialties, or patient diseases.

Researchers collected shared medical claims and insurance registration data from the OptumLabs data warehouse and county-level characteristics from the US census, as well as publicly available data on COVID-19 cases per county.

Individuals who were enrolled on a medical plan continuously for 12 months from July 2019 to June 2020 were enrolled in the study.

The researchers defined the period before COVID-19 as January 1, 2020 to March 17, 2020 and the period of COVID-19 as March 18, 2020 to June 16, 2020. According to the researchers, March 18 was chosen as the start of the COVID- 19 period since CMS announced the day before that it would expand telehealth services covered for the pandemic.

The final sample included 16,740,365 participants, of whom 78.5% had commercial insurance and 87.7% lived in urban communities.

Patel and colleagues found that 30.1% of all visits during the COVID-19 period were via telemedicine.

In addition, they found that the weekly number of telemedicine visits increased from 16,540 to 397,977 per week – a 23-fold increase – from pre-COVID-19 to pre-COVID-19.

Although the number of telemedicine visits has increased, the total visit volume decreased by 35% from pre-COVID-19 to pre-COVID-19.

Patel and colleagues found that the percentage of total telemedicine visits was lowest in adults aged 65 and over, at 23.7%, compared with 38.7% in adults aged 30 to 39.

At 23.9%, the researchers found that rural counties had a lower proportion of telemedicine visits during the COVID-19 period than 30.7% of visits to urban counties.

Among the specialties, Telehealth was used at least once by 67.7% of the endocrinologists, 57% of the gastroenterologists and 56.3% of the neurologists. In some specialist areas, however, the use of telemedicine was considerably lower: only 3.3% of opticians, 6.6% of physiotherapists, 9.3% of ophthalmologists and 20.7% of orthopedic surgeons used telemedicine at least once during the pandemic.

“Consistent with concerns about the ‘digital divide’ in access to telemedicine, we noted lower telemedicine use in high-poverty countries during COVID-19, while changes in overall visits were similar,” wrote Patel and colleagues.

They added that the “digital divide” was also observed in the use of telehealth in rural areas.

“One possible explanation for this finding is that limited broadband availability in rural areas is an obstacle to the use of telemedicine,” wrote Patel and colleagues.

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