Patients’ Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study (Preprint) DOI
Eli Kristiansen, Helen Atherton, Bjarne Austad

et al.

Published: Dec. 5, 2023

BACKGROUND e-Consultations, defined as asynchronous text-based messaging, have transformed how patients interact with their general practitioner (GP). While e-consultations can improve patient access to GP care, concerns about increased workload for GPs are raised. OBJECTIVE This study aimed address three research questions: (1) For what purpose and expectations do initiate e-consultations? (2) If had not been available, alternative actions would the taken? (3) How associated e-consultation characteristics? METHODS A cross-sectional was conducted through a web-based survey on Helsenorge. Helsenorge is national citizen portal digital health services in Norway, including GP. All users who sent were invited participate between January February 2023. The addressed questions users’ experience e-consultations. association characteristics analyzed using multinomial logistic regression. RESULTS Overall, 13,011 answered survey. most common reason initiating an requesting sick certificate (4940/13,011, 38%). 68.7% (8802/13,011) of respondents expected answer within 24 hours, 17.7% (2310/13,011) anticipated that ask them attend physical examination. 45.5% (5917/13,011) booked appointment, 44.9% (5846/13,011) called front desk. Users quicker response (odds ratio [OR] 1.64, 95% CI 1.46-1.85) less concerned issues (OR 1.29, 1.18-1.40) more likely call Only 2.5% (323/13,011) contacted out-of-hours services. longer travel time office 6.08, 3.46-10.66) new problem 2.71, 2.09-3.51) choose this option. In addition, 4.7% (609/13,011) sought help if available. Younger 2.16, 1.38-3.37) those 2.19, 1.27-3.80) or issue 1.74, 1.43-2.12) higher odds seeking help. CONCLUSIONS e-Consultations often patients’ first choice route, fast response. mostly perceived appointments calling Patients lower availability service waiting care. Guidance use should be developed ensure appropriate safe use. Further assess effect outcomes efficiency.

Language: Английский

Telehealth Expansion and Medicare Beneficiaries’ Care Quality and Access DOI Creative Commons

Morteza Saharkhiz,

Tanvi Rao,

Sara Parker‐Lue

et al.

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(5), P. e2411006 - e2411006

Published: May 13, 2024

Importance Understanding the association of telehealth use with health care outcomes is fundamental to determining whether waivers implemented during COVID-19 public emergency should be made permanent. The current literature has yielded inconclusive findings owing its focus on select states, practices, or systems. Objective To estimate for all Medicare fee-for-service (FFS) beneficiaries by comparing hospital service areas (HSAs) different levels use. Design, Setting, and Participants This US population-based, retrospective cohort study was conducted from July 2022 April 2023. included claims attributed HSAs FFS enrollment in Parts A B. Exposures Low, medium, high tercile created ranking according number visits per 1000 beneficiaries. Main Outcomes Measures primary were quality (ambulatory care–sensitive [ACS] hospitalizations department [ED] beneficiaries), access (clinician encounters beneficiary), cost (total Part and/or B services beneficiary) determined a difference-in-difference analysis. Results In this approximately 30 million (mean [SD] age 2019, 71.04 [1.67] years; mean percentage female 53.83% [2.14%]) within 3436 HSAs, between second half 2019 2021, ACS ED declined sharply, clinician beneficiary slightly, total semester increased slightly. Compared low group, group had more (1.63 additional beneficiaries; 95% CI, 1.03-2.22 hospitalizations), (0.30 semester; 0.23-0.38 encounters), higher ($164.99 $101.03-$228.96). There no statistically significant difference groups. Conclusions Relevance across associated encounters, hospitalizations, costs. cases still period study, which suggests that these partially reflect capacity providing intensity than other HSAs.

Language: Английский

Citations

10
Telemedicine Versus In-Person Primary Care: Treatment and Follow-up Visits DOI
Mary E. Reed, Jie Huang, Madeline Somers

et al.

Annals of Internal Medicine, Journal Year: 2023, Volume and Issue: 176(10), P. 1349 - 1357

Published: Oct. 1, 2023

Beyond initial COVID-19 pandemic emergency expansions of telemedicine use, it is unclear how well primary care addresses patients' needs.

Language: Английский

Citations

21
Telemental Health Services Usage and Association with Health Care Utilization and Expenditures Among Vulnerable Medicare Beneficiaries in 2019: A Comparative Study Using Propensity Score Matching DOI
Yunxi Zhang, Maria T. Peña, Lincy S. Lal

et al.

Telemedicine Journal and e-Health, Journal Year: 2024, Volume and Issue: 30(7), P. 1848 - 1856

Published: March 28, 2024

Telemental health (TMH) offers a promising approach to managing major depressive disorder (MDD). The objective of our work was evaluate TMH usage among vulnerable population MDD Medicare beneficiaries and its association with care utilization expenditures.

Language: Английский

Citations

6
Patients’ Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study DOI Creative Commons
Eli Kristiansen, Helen Atherton, Bjarne Austad

et al.

Journal of Medical Internet Research, Journal Year: 2025, Volume and Issue: 27, P. e55158 - e55158

Published: Jan. 8, 2025

Background e-Consultations, defined as asynchronous text-based messaging, have transformed how patients interact with their general practitioner (GP). While e-consultations can improve patient access to GP care, concerns about increased workload for GPs are raised. Objective This study aimed address three research questions: (1) For what purpose and expectations do initiate e-consultations? (2) If had not been available, alternative actions would the taken? (3) How associated e-consultation characteristics? Methods A cross-sectional was conducted through a web-based survey on Helsenorge. Helsenorge is national citizen portal digital health services in Norway, including GP. All users who sent were invited participate between January February 2023. The addressed questions users’ experience e-consultations. association characteristics analyzed using multinomial logistic regression. Results Overall, 13,011 answered survey. most common reason initiating an requesting sick certificate (4940/13,011, 38%). 68.7% (8802/13,011) of respondents expected answer within 24 hours, 17.7% (2310/13,011) anticipated that ask them attend physical examination. 45.5% (5917/13,011) booked appointment, 44.9% (5846/13,011) called front desk. Users quicker response (odds ratio [OR] 1.64, 95% CI 1.46-1.85) less concerned issues (OR 1.29, 1.18-1.40) more likely call Only 2.5% (323/13,011) contacted out-of-hours services. longer travel time office 6.08, 3.46-10.66) new problem 2.71, 2.09-3.51) choose this option. In addition, 4.7% (609/13,011) sought help if available. Younger 2.16, 1.38-3.37) those 2.19, 1.27-3.80) or issue 1.74, 1.43-2.12) higher odds seeking help. Conclusions e-Consultations often patients’ first choice route, fast response. mostly perceived appointments calling Patients lower availability service waiting care. Guidance use should be developed ensure appropriate safe use. Further assess effect outcomes efficiency.

Language: Английский

Citations

0
How Chinese digital healthcare is different from the United States? A systematic review DOI
Amir Khushk, Yi Xu, Zhiying Liu

et al.

Technology Analysis and Strategic Management, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: Feb. 24, 2025

Language: Английский

Citations

0
Cost Minimization Analysis of Digital-first Healthcare Pathways in Primary Care DOI Creative Commons

Angela Dahlberg,

Sakari Jukarainen, Taavi Kaartinen

et al.

Published: April 4, 2025

Abstract A retrospective, registry-based cost-minimization analysis assessed whether initiating acute primary care episodes via a digital-first pathway reduces costs compared to traditional in Finnish setting (Harjun Terveys). Of 637,923 encounters, 64,969 eligible were identified. After propensity score matching (19,697 pairs), mean episode significantly lower the digital (€170.74) than (€220.91), reflecting 22.7% reduction ( P <.001). Savings varied by clinical presentation, from 10.3% for respiratory infections 52.5% gastroenteritis (all Digital was associated with use of laboratory tests and imaging. Follow-up visits generally fewer group, except infections, which showed slight increase. Sensitivity analyses 7- 30-day follow-up windows confirmed findings. Overall, this study supports models as cost-effective strategy managing conditions care, potential reduce unnecessary resource without compromising continuity care.

Language: Английский

Citations

0
Utilization and quality among Medicare Advantage beneficiaries with high vs low access to telehealth DOI Creative Commons
Jiani Yu, Lawrence P. Casalino, Hye‐Young Jung

et al.

Health Affairs Scholar, Journal Year: 2025, Volume and Issue: 3(4)

Published: March 26, 2025

Abstract Access to telehealth care has increased markedly in recent years, especially for patients the Medicare Advantage (MA) program. Given unique features of MA, such as capitated payment and provider networks, understanding impact availability on quality, costs, utilization is important informing coverage decisions. We compared quality outcomes among MA beneficiaries with varying access telehealth, using encounter data from a 20% national random sample enrollees 2019 2021. found that high-telehealth was associated 13.4% decrease in-person evaluation management (E&M) visits, relative period prior pandemic onset. this offset by increases E&M there no change total visits. High-telehealth also 4.8% emergency department (ED) but differences preventable ED hospital admissions, or ambulatory care-sensitive admissions. Increases telehealth-delivered visits decreases in-person-delivered These findings may help clinicians policymakers contextualize relationship between broader various types health utilization.

Language: Английский

Citations

0
Telehealth use during the early COVID-19 public health emergency and subsequent health care costs and utilization DOI Creative Commons
Jun Soo Lee, Ami Bhatt, Lisa M. Pollack

et al.

Health Affairs Scholar, Journal Year: 2024, Volume and Issue: 2(1)

Published: Jan. 1, 2024

Abstract Telehealth utilization increased during the COVID-19 pandemic, yet few studies have documented associations of telehealth use with subsequent medical costs and health care utilization. We examined early public emergency (March–June 2020) total among people heart disease (HD). created a longitudinal cohort individuals HD using MarketScan Commercial Claims data (2018–2022). used difference-in-differences methodology adjusting for patients’ characteristics, comorbidities, infection status, number in-person visits. found that stay-at-home order period was associated reduction in (by −$1814 per person), department visits −88.6 1000 persons), inpatient admissions −32.4 persons). per-person per-year pharmacy prescription claims 0.514) average days’ drug supply 0.773 days). These benefits can inform decision makers, insurance companies, professionals, especially context disrupted access.

Language: Английский

Citations

3
Complex role of individual digital skills and eHealth policies in shaping health policy DOI Creative Commons
Lucia Leporatti, Marcello Montefiori

Socio-Economic Planning Sciences, Journal Year: 2024, Volume and Issue: 93, P. 101897 - 101897

Published: April 16, 2024

The COVID-19 pandemic has significantly impacted individuals' physical and mental health worldwide. Using data from the Survey of Health, Aging, Retirement in Europe (SHARE) a comparative approach across European countries, this study investigates potential protective effect individual digital skills eHealth policies mitigating effects. Our analysis exploits within-between random effects shows that individuals with null or poor have 2.4% higher likelihood experiencing worsening status 4% probability issues. At same time, living countries characterized by high levels digitalization minimizes range between 1% 2.7%. on is much stronger. However, relationship outcomes influenced country-specific level digitalization. Indeed, impact having more substantial if one lives country where widespread. These results show rapid advancement healthcare could exacerbate inequality unless accompanied development among population.

Language: Английский

Citations

3
The Provision of Abortion Care via Telehealth in the United States: A Rapid Review DOI Creative Commons
Camille Brown, Carrie E. Neerland, Elizabeth Weinfurter

et al.

Journal of Midwifery & Women s Health, Journal Year: 2023, Volume and Issue: 68(6), P. 744 - 758

Published: Nov. 1, 2023

Introduction The recent Supreme Court decision Dobbs v. Jackson Women's Health that has overruled Roe Wade resulted in severe limitations of abortion access throughout the United States. Telehealth been put forth as one solution for improving reproductive health care, including services. demonstrated safety and efficacy several care disciplines; however, its use services not explored synthesized. Methods As part a larger review on telehealth general health, our team identified moderate amount literature care. We conducted rapid searching eligible studies MEDLINE, Embase, CINAHL. Information was extracted from each included study to explore 4 key areas inquiry: (1) clinical effectiveness, (2) patient provider experiences, (3) barriers facilitators, (4) impact coronavirus disease 2019 (COVID‐19) pandemic. Results Twenty‐five providing published between 2011 2022 were included. medical increased during COVID‐19 pandemic found be safe clinically effective, with high satisfaction. Overall, improved removed patients lack transportation. Legal restrictions certain states cited primary barriers. Studies contained limited information perspectives experiences providers diverse populations. Discussion Abortion via is effective satisfaction may also remove transportation fear. Removing provision further improve promote greater equity.

Language: Английский

Citations

8