Research brief
Telemedicine has expanded outpatient neurology care, yet its effectiveness compared to traditional in-person visits remains under scrutiny. A recent study examined health care utilisation following virtual versus in-person neurology appointments at three academic medical centres. This retrospective analysis covered over 16,000 matched patient visits, focusing on follow-up visits, emergency department (ED) visits, and hospitalisations. The findings indicate that virtual visits are generally comparable to in-person visits in terms of subsequent health care utilisation, though some differences emerge based on the patient’s initial complaint.
Key points
- Virtual and in-person neurology visits show similar follow-up rates.
- Emergency visits and hospitalisations are comparable between visit types.
- Follow-up varies by initial neurological complaint.
Study Design and Methodology
The study spanned three academic medical centres and involved a retrospective analysis of adult patients who had new outpatient neurology visits between September 2020 and December 2021. Researchers used the Vizient Clinical Data Base and Clinical Practice Solutions Center databases to match 8,202 virtual visits with 8,202 in-person visits through propensity scores. These scores considered demographics, clinical characteristics, time period, and previous health care utilisation, ensuring a balanced comparison between the two groups.
Key Findings on Follow-Up and Utilisation
The study found no significant difference in neurology follow-up within 90 days between virtual and in-person visits, with rates of 24.6% and 23.7% respectively. Although 30-day follow-up was slightly lower for virtual visits, follow-up at six months and one year was similar across both groups. Neurologic ED visits and hospitalisations within 90 days were also similar, with no significant differences in all-cause ED visits and hospitalisations.
Variation by Neurological Condition
The analysis showed some differences in follow-up rates based on the initial neurological complaint. For instance, 90-day follow-up was higher after in-person visits for dementia. Conversely, virtual visits had higher follow-up rates for conditions like Parkinson’s disease, multiple sclerosis, and headaches. Additionally, testing was more frequent after in-person visits for certain complaints, indicating areas where in-person assessments may still offer advantages.
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