SHM Converge Scientific Abstract ePoster Gallery-Association of Telemedicine Follow-Up After Hospitalization and 30-Day Readmission: A Comparative Analysis of Pre-Covid and Covid-19 Periods in a Large Integrated Healthcare System

Association of Telemedicine Follow-Up After Hospitalization and 30-Day Readmission: A Comparative Analysis of Pre-Covid and Covid-19 Periods in a Large Integrated Healthcare System

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This retrospective cohort study examined whether telemedicine follow-up within 7 days after hospital discharge was associated with worse 30-day outcomes than in-person office visits in Kaiser Permanente Northern California. Adults discharged from the Medicine Service were included from January 2017 through December 2021, excluding patients with hospice/SNF discharge, transfers, in-hospital death, or COVID-19 admissions.<br /><br />A total of 99,479 discharges were analyzed: 66,166 in the pre-COVID period and 33,313 during COVID-19. Telemedicine use rose dramatically during the pandemic, accounting for 93.2% of follow-up visits compared with 28.2% before COVID-19.<br /><br />Overall, unadjusted 30-day readmission was slightly higher after telemedicine than office visits (9.9% vs 8.4%), as were ED visits (13.1% vs 12.6%) and mortality (2.1% vs 1.1%). However, adjusted analyses showed that this pattern differed by time period. Before COVID-19, telemedicine was associated with higher readmission risk (aHR 1.24) and higher ED use (aHR 1.12), as well as higher mortality (aHR 1.87). During COVID-19, telemedicine was not associated with increased readmission (aHR 0.92), ED visits (aHR 0.88), or mortality (aHR 1.10; not significant).<br /><br />The authors conclude that broad telemedicine follow-up during the pandemic was not linked to worse short-term post-discharge outcomes and may be a safe, accessible option for follow-up care, especially for patients with barriers to in-person visits. They suggest that a hybrid model combining telemedicine and office visits based on clinical need may be optimal.

Asset Subtitle

Michael S. Yoo

Meta Tag

Author List Kawai Cheung, Lawrence S. Block, Lue-Yen Tucker, Mary Reed, Michael S. Yoo

Category Research

Concept Telemedicine Follow-up

Concept 30-Day Readmission

Concept In-person Office Visit

Concept Emergency Department Visits

Concept Mortality

Distinguished Non-Finalist

Presenter Organization The Permanente Medical Group

Presenting Author Michael S. Yoo

Track Outcomes Research

Keywords

telemedicine

hospital discharge

follow-up care

30-day readmission

emergency department visits

mortality

retrospective cohort study

Kaiser Permanente

COVID-19 pandemic

hybrid care model

Telemedicine Follow-up

30-Day Readmission

In-person Office Visit

Emergency Department Visits

Mortality