Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic
Background The COVID‐19 pandemic resulted in a rapid implementation of telemedicine into clinical practice. This study examined whether early outpatient follow‐up via telemedicine is as effective as in‐person visits for reducing 30‐day readmissions in patients with heart failure. Methods and Results...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.023935 |
| _version_ | 1797849670186172416 |
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| author | Hanzhang Xu Bradi B. Granger Connor D. Drake Eric D. Peterson Matthew E. Dupre |
| author_facet | Hanzhang Xu Bradi B. Granger Connor D. Drake Eric D. Peterson Matthew E. Dupre |
| author_sort | Hanzhang Xu |
| collection | DOAJ |
| description | Background The COVID‐19 pandemic resulted in a rapid implementation of telemedicine into clinical practice. This study examined whether early outpatient follow‐up via telemedicine is as effective as in‐person visits for reducing 30‐day readmissions in patients with heart failure. Methods and Results Using electronic health records from a large health system, we included patients with heart failure living in North Carolina (N=6918) who were hospitalized between March 16, 2020 and March 14, 2021. All‐cause readmission within 30 days after discharge was examined using weighted logistic regression models. Overall, 7.6% (N=526) of patients received early telemedicine follow‐up, 38.8% (N=2681) received early in‐person follow‐up, and 53.6% (N=3711) did not receive follow‐up within 14 days of discharge. Compared with patients without early follow‐up, those who received early follow‐up were younger, were more likely to be Medicare beneficiaries, had more comorbidities, and were less likely to live in an disadvantaged neighborhood. Relative to in‐person visits, those with telemedicine follow‐up were of similar age, sex, and race but with generally fewer comorbidities. Overall, the 30‐day readmission rate (19.0%) varied among patients who received telemedicine visits (15.0%), in‐person visits (14.0%), or no follow‐up (23.1%). After covariate adjustment, patients who received either telemedicine (odds ratio [OR], 0.55; 95% CI, 0.44–0.72) or in‐person (OR, 0.52; 95% CI, 0.45–0.60) visits were similarly less likely to be readmitted within 30 days compared with patients with no follow‐up. Conclusions During the COVID‐19 pandemic, the use of telemedicine visits for early follow‐up increased rapidly. Patients with heart failure who received outpatient follow‐up either via telemedicine or in‐person had better outcomes than those who received no follow‐up. |
| first_indexed | 2024-04-09T18:47:47Z |
| format | Article |
| id | doaj.art-e6c93084c8554759b8ac8ce820ee8758 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T18:47:47Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-e6c93084c8554759b8ac8ce820ee87582023-04-10T11:57:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-04-0111710.1161/JAHA.121.023935Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 PandemicHanzhang Xu0Bradi B. Granger1Connor D. Drake2Eric D. Peterson3Matthew E. Dupre4Department of Family Medicine and Community Health Duke University Durham NCDuke University School of Nursing Duke University Durham NCDepartment of Population Health Sciences Duke University Durham NCOffice of the Provost University of Texas Southwestern Medical Dallas TXCenter for the Study of Aging and Human Development Duke University Durham NCBackground The COVID‐19 pandemic resulted in a rapid implementation of telemedicine into clinical practice. This study examined whether early outpatient follow‐up via telemedicine is as effective as in‐person visits for reducing 30‐day readmissions in patients with heart failure. Methods and Results Using electronic health records from a large health system, we included patients with heart failure living in North Carolina (N=6918) who were hospitalized between March 16, 2020 and March 14, 2021. All‐cause readmission within 30 days after discharge was examined using weighted logistic regression models. Overall, 7.6% (N=526) of patients received early telemedicine follow‐up, 38.8% (N=2681) received early in‐person follow‐up, and 53.6% (N=3711) did not receive follow‐up within 14 days of discharge. Compared with patients without early follow‐up, those who received early follow‐up were younger, were more likely to be Medicare beneficiaries, had more comorbidities, and were less likely to live in an disadvantaged neighborhood. Relative to in‐person visits, those with telemedicine follow‐up were of similar age, sex, and race but with generally fewer comorbidities. Overall, the 30‐day readmission rate (19.0%) varied among patients who received telemedicine visits (15.0%), in‐person visits (14.0%), or no follow‐up (23.1%). After covariate adjustment, patients who received either telemedicine (odds ratio [OR], 0.55; 95% CI, 0.44–0.72) or in‐person (OR, 0.52; 95% CI, 0.45–0.60) visits were similarly less likely to be readmitted within 30 days compared with patients with no follow‐up. Conclusions During the COVID‐19 pandemic, the use of telemedicine visits for early follow‐up increased rapidly. Patients with heart failure who received outpatient follow‐up either via telemedicine or in‐person had better outcomes than those who received no follow‐up.https://www.ahajournals.org/doi/10.1161/JAHA.121.023935electronic health recordsheart failurehospitalizationtelemedicine |
| spellingShingle | Hanzhang Xu Bradi B. Granger Connor D. Drake Eric D. Peterson Matthew E. Dupre Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease electronic health records heart failure hospitalization telemedicine |
| title | Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic |
| title_full | Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic |
| title_fullStr | Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic |
| title_full_unstemmed | Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic |
| title_short | Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic |
| title_sort | effectiveness of telemedicine visits in reducing 30 day readmissions among patients with heart failure during the covid 19 pandemic |
| topic | electronic health records heart failure hospitalization telemedicine |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.023935 |
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