Introduction: While insurance companies are increasingly providing coverage for telehealth services, such as video visits, and healthcare providers are increasingly utilizing these modes of healthcare delivery, the impact of video visits on cost and quality is largely unknown. One important question is whether a video visit can serve as a substitute for in-person care or whether the use of video visits will lead to additional downstream in-person visits (i.e., expansion of healthcare utilization).
Methods: We reviewed 141 consecutive, established patient video visits completed with four urologists at our institution. We then randomly sampled 141 established patient clinic visits to serve as our comparison group. After evaluating baseline demographics of the patients in the two groups, we determined whether video visits served as a substitute for in-person care or as an expansion of healthcare services, by comparing the number of additional visits (i.e., revisits) that occurred within 30 days of each type of encounter.
Results: There was no difference in revisit rates after video visits (4%, n=6) compared to clinic visits (6%, n=9; p=0.42). Patients that were seen via video visits tended to be younger (54.9 vs 62.7 years, p<0.001). Differences in the distance from the hospital (72 vs 64.5 miles, p=0.65) and median income ($51,402 vs $53,239, p=0.46) were not statistically significant. The most common diagnoses evaluated through video visit encounters were urolithiasis (38%), kidney or upper tract malignancy (18%), followed by elevated PSA (10%), prostate cancer (7%), and voiding issues (7%).
Conclusions: Video visits served as a substitute for traditional clinic visits and were used by patients with a broad range of urologic conditions. These findings suggest that the expansion of synchronous telemedicine coverage by private payers may not necessarily increase the utilization of healthcare services. Source of
