A recent study published in JAMA Network Open has discovered that patients who had telehealth follow-up visits after consulting the emergency department (ED) were more likely to visit the ED again and be admitted to the hospital than those who received follow-up visits in person. The UCLA study compared hospitalization rates and subsequent ED visits for patients who had in-person follow-ups following their first ED visits to those who had virtual follow-up visits. The data included 12,848 adult patients who had visited one of the two EDs at an integrated urban academic health between April 1, 2020, and September 30, 2021. Each of the study’s participants were discharged from the ED and took part in a follow-up consultation with a primary care physician.
The researchers found that 17 percent culminated in a return visit, and 4 percent resulted in the patient being admitted to the hospital. 16 percent of patients who received a post-ED follow-up consultation in person went back to the ED, and 4 percent were admitted to the hospital within 30 days. 18% of patients who took part in a virtual follow-up visit after being discharged from the ED returned, and 5% were admitted to the hospital within 30 days. Following adjustment, the data revealed that, in comparison to in-person follow-ups, telehealth follow-up visits were linked to 10.6 more hospitalizations and 28.3 more ED return visits per 1,000 interactions.
According to the study’s leader Dr. Vivek Shah, UCLA researchers have proposed one potential solution to the problem. They suggest a telehealth triage system that considers patient complaints to decide whether or not a telehealth evaluation is suitable in each circumstance.
The researchers pointed to a number of limitations to their study’s findings, however. The limitations could have affected who received in-person care and who sought advice via telehealth, among other unmeasured variables. The study was only conducted at UCLA Health medical institutions, and certain data from uninsured populations were missing, thus the findings might not be applicable in other contexts. However, the researchers draw the conclusion that their data requires more investigation to assess the suitability of telehealth as a medium for post-ED follow-up.