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Quality Of Care For Acute Respiratory Infections During Direct-To-Consumer Telemedicine Visits For Adults

Year: 2018

Type: article

Abstract: In direct-to-consumer telemedicine, physicians treat patients through real-time audiovisual conferencing for common conditions such as acute respiratory infections. Early studies had mixed findings on the quality of care provided during direct-to-consumer telemedicine and were limited by small sample sizes and narrow geographic scopes. Using claims data for 2015-16 from a large national commercial insurer, we examined the quality of antibiotic management in adults with acute respiratory infection diagnoses at 38,839 direct-to-consumer telemedicine visits, compared to the quality at 942,613 matched primary care visits and 186,016 matched urgent care visits. In the matched analyses, we found clinically similar rates of antibiotic use, broad-spectrum antibiotic use, and guideline-concordant antibiotic management. However, direct-to-consumer telemedicine visits had less appropriate streptococcal testing and a higher frequency of follow-up visits. These results suggest specific opportunities for improvement in direct-to-consumer telemedicine quality.

Source: Health Affairs

DOI: 10.1377/hlthaff.2018.05091

Authors: Zhuo Shi, Ateev Mehrotra, Courtney A. Gidengil, Sabrina J. Poon, Lori Uscher-Pines, Kristin N. Ray

Institutions: Harvard University, RAND Corporation, Vanderbilt University, University of Pittsburgh

Language: English

Topic: Telemedicine and Telehealth Implementation

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: Eunice Kennedy Shriver National Institute of Child Health and Human Development