Physician-Led Synchronous Telemedicine Compared to Face-To-Face Care in Primary Care: A Systematic Review

Evaluation & the Health Professions, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 14, 2024

The COVID-19 crisis rapidly introduced telemedicine as the predominate modality to deliver healthcare however this change has not received attention in primary care settings and health-related impacts are unknown. study's objective was explore effects of physician-led synchronous compared face-to-face delivered setting on system use attributes reported recent studies. We performed a comprehensive literature search five databases (MEDLINE, Embase, Cochrane Database Systematic Reviews, Central Register Controlled Trials, PsycInfo) critical appraisal using Joanna Briggs Institute tools. Of 6,247 studies identified, 157 underwent full text review, 19 were included. Most conducted U.S. (78.9%) used video telephone (57.9%). An outcome-based qualitative description narrative synthesis showed similar or fewer emergency department visits, hospital prescribing, diagnostic tests imaging for visits care. Our systematic review fills gap our results need be interpreted cautiously given studies' susceptibility selection bias, confounding, limited applicability other health systems time periods.

Language: Английский

Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Nov. 18, 2023

Abstract BACKGROUND Telehealth has emerged as an effective tool for managing common chronic conditions such hypertension, especially during the COVID-19 pandemic. However, impact of state telehealth payment and coverage parity laws on hypertension management remains uncertain. METHODS Data from Merative TM MarketScan® Commercial Claims Encounters Database January 1, 2016 to December 31, 2021 were used construct study cohort. The sample included non-pregnant individuals aged 25–64 years with hypertension. We reviewed coded related in all 50 states District Columbia, distinguishing between laws. primary outcomes antihypertension medication use, measured by average possession ratio (MPR), adherence (MPR ≥80%), number days drug supply. a generalized difference-in-difference (DID) design examine these Results presented marginal effects 95% confidence intervals (CI). RESULTS Among 353,220 individuals, significantly linked increased MPR 0.43 percentage point (95% CI: 0.07 - 0.79), increase 0.46 0.06 0.92) probability adherence. Payment also led 2.14 0.11 4.17) antihypertensive supply, after controlling state-fixed effects, year-fixed individual sociodemographic characteristics time-varying covariates including unemployment rates, GDP per capita, poverty rates. In contrast, associated 2.13-day 0.19 4.07) but did not or addition, positively hypertension-related visits, this effect reach statistical significance. These findings consistent sensitivity analyses. CONCLUSIONS State greater adherence, whereas not. With increasing adoption across states, may support policymakers understanding potential implications Clinical Perspective What Is New? is manage state-level can influence its application. Prior studies have clearly differentiated impacts parity. Using quasi-experimental difference-in-differences design, we assessed management. Our found that while Are Implications? widespread management, emergencies like pandemic beyond. Considering approximately half adult population, our provides valuable insights into benefits private payers enhancing integrating holds significant evolving U.S. healthcare system digital age.

Language: Английский

Patients’ Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study (Preprint)

Published: Dec. 5, 2023

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. 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? 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. 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. 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