Journal of Developmental & Behavioral Pediatrics ( IF 2.4 ) Pub Date : 2022-06-01 , DOI: 10.1097/dbp.0000000000001040 Asher Ripp 1 , Caren Steinway 1, 2 , Michelle Weiss Katzow 1, 2, 3 , Sophia Jan 1, 2 , Jack Chen 1 , Victoria Chen 2, 4
Objective:
The goal of this study was to understand the effect of transition to telehealth care on follow-up visit attendance in a developmental-behavioral pediatric (DBP) practice in 2020 versus in-person care in 2019.
Methods:
This was a retrospective observational cohort study of follow-up visits occurring in a large DBP practice during a 6-week period in March/April of 2019 and 2020. The primary outcome was follow-up visit adherence, defined as completion of scheduled follow-up visit. The primary exposure was telehealth visit in 2020 versus in-person visit in 2019. Covariates included patient demographics and clinical characteristics. Data were analyzed using descriptive statistics and logistic regression.
Results:
The cohort included 2142 visits for 1868 unique patients. The patient mean age was 9.2 ± 4.8 years, with 73.4% male, 56.5% non-Hispanic, 51.4% White, and 68.3% commercial insurance. There were 470 telehealth visits from March to April 2020 and 1672 in-person visits from March to April 2019. Compared with in-person visits, telehealth visits were more likely to be completed (75.3% vs 64.4%, p < 0.001). After adjusting for age, sex, race, ethnicity, insurance, and week of visit (weeks 1–3 vs 4–6), odds of having a complete follow-up visit were higher for telehealth visits than for in-person visits (odds ratio = 1.57; 95% confidence interval [1.23–2.00], p < 0.001).
Conclusion:
Follow-up visit attendance was higher for telehealth care in 2020 than in-person care in 2019. This association persisted after adjusting for insurance, age, race, and ethnicity, suggesting that telehealth is associated with increased follow-up visit attendance in DBP care. Further studies are needed to understand the impact of telehealth on DBP clinical outcomes in chronic disease management.
中文翻译:
2020 年 COVID-19 大流行期间儿科发育行为的远程医疗利用和随访
客观的:
本研究的目的是了解在 2020 年发展行为儿科 (DBP) 实践中过渡到远程医疗保健与 2019 年面对面护理相比,对随访出勤率的影响。
方法:
这是一项回顾性观察队列研究,针对 2019 年 3 月/4 月和 2020 年 6 周期间大型 DBP 实践中进行的随访进行。主要结果是随访依从性,定义为完成预定的随访上来参观。主要暴露是 2020 年的远程医疗就诊与 2019 年的面对面就诊。协变量包括患者人口统计数据和临床特征。使用描述性统计和逻辑回归分析数据。
结果:
该队列包括 1868 名独特患者的 2142 次就诊。患者平均年龄为 9.2 ± 4.8 岁,其中 73.4% 为男性,56.5% 非西班牙裔,51.4% 为白人,68.3% 有商业保险。2020 年 3 月至 4 月期间有 470 次远程医疗就诊,2019 年 3 月至 4 月有 1672 次亲自就诊。与亲自就诊相比,远程医疗就诊更有可能完成(75.3% vs 64.4%,p < 0.001 )。在调整年龄、性别、种族、民族、保险和就诊周(第 1-3 周与第 4-6 周)后,远程医疗就诊进行完整随访的几率高于亲自就诊的几率(几率比率 = 1.57;95% 置信区间 [1.23–2.00],p < 0.001)。
结论:
2020 年远程医疗保健的随访出勤率高于 2019 年的现场护理。在调整保险、年龄、种族和民族后,这种关联仍然存在,表明远程医疗与 DBP 护理中随访出勤率的增加有关。需要进一步的研究来了解远程医疗对慢性病管理中 DBP 临床结果的影响。