Transition to telemedicine and its impact on missed appointments in community-based clinics
Background and objective The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relations...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/07853890.2021.2019826 |
| _version_ | 1818978248061616128 |
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| author | Omolola E. Adepoju Minji Chae Winston Liaw Tracy Angelocci Paul Millard Omar Matuk-Villazon |
| author_facet | Omolola E. Adepoju Minji Chae Winston Liaw Tracy Angelocci Paul Millard Omar Matuk-Villazon |
| author_sort | Omolola E. Adepoju |
| collection | DOAJ |
| description | Background and objective The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic. Method This retrospective study used appointment-level data from 55 Federally Qualified Health Centre clinics in Texas between March and November 2020. To account for the nested data structure of repeated appointments within each patient, a mixed-effects multivariable logistic regression model was used to examine associations between telemedicine use and missed appointments, adjusting for patient sociodemographic characteristics, geographic classification, past medical history, and clinic characteristics. The independent variable was having a telemedicine appointment, defined as an audiovisual consultation started and finalized via a telemedicine platform. The outcome of interest was having a missed appointment (yes/no) after a scheduled and confirmed medical appointment. Results from this initial model were stratified by appointment type (in-person vs. telemedicine). Results The analytic sample included 278,171 appointments for 85,413 unique patients. The overall missed appointment rate was 18%, and 25% of all appointments were telemedicine appointments. Compared to in-person visits, telemedicine visits were less likely to result in a missed appointment (OR = 0.87, p < .001). Compared to Whites, Asians were less likely to have a missed appointment (OR = 0.82, p < .001) while African Americans, Hispanics, and American Indians were all significantly more likely to have missed appointments (OR = 1.61, p < .001; OR = 1.19, p = .01; OR = 1.22, p < .01, respectively). Those accessing mental health services (OR = 1.57 for in-person and 0.78 for telemedicine) and living in metropolitan areas (OR = 1.15 for in-person and 0.82 for telemedicine) were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Patients with frequent medical visits or those living with chronic diseases were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Conclusions Telemedicine is strongly associated with fewer missed appointments. Although our findings suggest a residual lag in minority populations, specific patient populations, including those with frequent prior visits or chronic conditions, those seeking mental health services, and those living in metropolitan areas were less likely to miss telemedicine appointments than in-person visits. These findings highlight how telemedicine can enable effective and accessible care by reducing missed healthcare appointments.KEY MESSAGES Telemedicine was associated with 13% lower odds of missed appointments. Patients with frequent medical visits or those living with chronic diseases were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Patients seeking mental health services were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Similarly, those living in metropolitan areas were less likely to miss telemedicine appointments but more likely to miss in-person appointments. |
| first_indexed | 2024-12-20T16:40:37Z |
| format | Article |
| id | doaj.art-513b6a4d2cb74ea5aa0073299dc862a0 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-12-20T16:40:37Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-513b6a4d2cb74ea5aa0073299dc862a02022-12-21T19:33:02ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602022-12-015419810710.1080/07853890.2021.20198262019826Transition to telemedicine and its impact on missed appointments in community-based clinicsOmolola E. Adepoju0Minji Chae1Winston Liaw2Tracy Angelocci3Paul Millard4Omar Matuk-Villazon5Department of Health Systems and Population Health Sciences, College of Medicine, University of HoustonHumana Integrated Health System Sciences Institute, University of HoustonDepartment of Health Systems and Population Health Sciences, College of Medicine, University of HoustonLone Star Circle of CareLone Star Circle of CareDepartment of Health Systems and Population Health Sciences, College of Medicine, University of HoustonBackground and objective The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic. Method This retrospective study used appointment-level data from 55 Federally Qualified Health Centre clinics in Texas between March and November 2020. To account for the nested data structure of repeated appointments within each patient, a mixed-effects multivariable logistic regression model was used to examine associations between telemedicine use and missed appointments, adjusting for patient sociodemographic characteristics, geographic classification, past medical history, and clinic characteristics. The independent variable was having a telemedicine appointment, defined as an audiovisual consultation started and finalized via a telemedicine platform. The outcome of interest was having a missed appointment (yes/no) after a scheduled and confirmed medical appointment. Results from this initial model were stratified by appointment type (in-person vs. telemedicine). Results The analytic sample included 278,171 appointments for 85,413 unique patients. The overall missed appointment rate was 18%, and 25% of all appointments were telemedicine appointments. Compared to in-person visits, telemedicine visits were less likely to result in a missed appointment (OR = 0.87, p < .001). Compared to Whites, Asians were less likely to have a missed appointment (OR = 0.82, p < .001) while African Americans, Hispanics, and American Indians were all significantly more likely to have missed appointments (OR = 1.61, p < .001; OR = 1.19, p = .01; OR = 1.22, p < .01, respectively). Those accessing mental health services (OR = 1.57 for in-person and 0.78 for telemedicine) and living in metropolitan areas (OR = 1.15 for in-person and 0.82 for telemedicine) were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Patients with frequent medical visits or those living with chronic diseases were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Conclusions Telemedicine is strongly associated with fewer missed appointments. Although our findings suggest a residual lag in minority populations, specific patient populations, including those with frequent prior visits or chronic conditions, those seeking mental health services, and those living in metropolitan areas were less likely to miss telemedicine appointments than in-person visits. These findings highlight how telemedicine can enable effective and accessible care by reducing missed healthcare appointments.KEY MESSAGES Telemedicine was associated with 13% lower odds of missed appointments. Patients with frequent medical visits or those living with chronic diseases were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Patients seeking mental health services were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Similarly, those living in metropolitan areas were less likely to miss telemedicine appointments but more likely to miss in-person appointments.http://dx.doi.org/10.1080/07853890.2021.2019826covid-19telemedicinepatient no-showsmissed appointmentsaccess to health carefederally qualified health centres |
| spellingShingle | Omolola E. Adepoju Minji Chae Winston Liaw Tracy Angelocci Paul Millard Omar Matuk-Villazon Transition to telemedicine and its impact on missed appointments in community-based clinics Annals of Medicine covid-19 telemedicine patient no-shows missed appointments access to health care federally qualified health centres |
| title | Transition to telemedicine and its impact on missed appointments in community-based clinics |
| title_full | Transition to telemedicine and its impact on missed appointments in community-based clinics |
| title_fullStr | Transition to telemedicine and its impact on missed appointments in community-based clinics |
| title_full_unstemmed | Transition to telemedicine and its impact on missed appointments in community-based clinics |
| title_short | Transition to telemedicine and its impact on missed appointments in community-based clinics |
| title_sort | transition to telemedicine and its impact on missed appointments in community based clinics |
| topic | covid-19 telemedicine patient no-shows missed appointments access to health care federally qualified health centres |
| url | http://dx.doi.org/10.1080/07853890.2021.2019826 |
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