Telehealth Use During the Early COVID-19 Public Health Emergency and Subsequent Health Care Costs and Utilization

Jun Soo Lee, Ami Bhatt, Lisa M Pollack, Sandra L. Jackson, Ji Eun Chang, Xin Tong, Feijun Luo
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Abstract

Telehealth utilization increased during the COVID-19 pandemic, yet few studies have documented associations of telehealth use with subsequent medical costs and health care utilization. We examined associations of telehealth use during the early COVID-19 public health emergency (March–June 2020) with subsequent total medical costs and health care utilization among people with heart disease (HD). We created a longitudinal cohort of individuals with HD using MarketScan Commercial Claims data (2018–2022). We used difference-in-difference methodology adjusting for patients’ characteristics, comorbidities, COVID-19 infection status, and number of in-person visits. We found that using telehealth during the stay-at-home order period was associated with a reduction in total medical costs (by -$1814 per person), number of emergency department visits (by -88.6 per 1,000 persons), and inpatient admissions (by -32.4 per 1,000 persons). Telehealth use increased per-person per-year pharmacy prescription claims (by 0.514) and average number of days’ drug supply (by.773 days). These associated benefits of telehealth use can inform decision makers, insurance companies, and health care professionals, especially in the context of disrupted health care access.
COVID-19 公共卫生突发事件早期的远程医疗使用情况及其后的医疗成本和使用情况
在 COVID-19 大流行期间,远程医疗的使用率有所增加,但很少有研究记录远程医疗的使用与后续医疗成本和医疗保健使用率之间的关系。我们研究了 COVID-19 公共卫生紧急事件早期(2020 年 3 月至 6 月)期间远程医疗的使用与心脏病(HD)患者随后的医疗总成本和医疗利用率之间的关系。我们利用 MarketScan 商业索赔数据(2018-2022 年)创建了一个 HD 患者纵向队列。我们采用差异法对患者的特征、合并症、COVID-19 感染状态和亲自就诊次数进行了调整。我们发现,在居家订单期间使用远程医疗与总医疗费用的减少(每人-1814 美元)、急诊就诊次数的减少(每千人-88.6 次)和住院人数的减少(每千人-32.4 次)相关。远程保健的使用增加了每人每年的药房处方报销次数(增加了 0.514 次)和平均药品供应天数(增加了 773 天)。使用远程保健的这些相关益处可以为决策者、保险公司和医疗保健专业人员提供信息,尤其是在医疗保健服务中断的情况下。
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