Comparing Clinical Outcomes and Health Care Utilization: Telehealth Versus Traditional Care at US Rural Hemodialysis Units

Abstract

Objective

To determine whether novel dialysis delivery models, such as telehealth visits combined with face-to-face visits in a hybrid model (telehealth hybrid model), positively influence clinical outcomes and healthcare utilization.

Patients and Methods

This retrospective cohort study compares the rates of emergency department visits, hospitalizations, and Medicare established hemodialysis quality metrics before and after implementation of a telehealth hybrid model focused among rural populations in regions served by the Mayo Clinic dialysis system between January 1, 2020, to December 31, 2020, versus face-to-face visits alone before implementation of the program from January 1, 2019, to December 31, 2019. In addition, we used a standardized anonymous survey to examine patient perspectives toward the implementation of telehealth at the dialysis units.

Results

No significant differences in health care utilization outcomes (emergency department visits: Incidence rate ratios, 95% CI, 0.87 (0.62-1.22); P=.41; hospitalizations: Incidence rate ratios, 95% CI, 0.92 (0.63-1.35); P=.68) or clinical outcomes (abnormal laboratory measures) between the telehealth and standard care groups were observed. Patient satisfaction with telehealth was high, with 90% reporting successful video visits.

Conclusion

Our study provides evidence suggesting that the telehealth hybrid model can deliver nephrology care comparable to traditional care models in in-center dialysis without negatively impacting clinical outcomes, health care utilization, or patient satisfaction. Further research is necessary to confirm these results in other settings and to explore the long-term impacts of such hybrid care models.