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Trends in telehealth and in-person transitional care management visits during the COVID-19 pandemic.
J Am Geriatr Soc. 2021 10; 69(10):2745-2751.JA

Abstract

BACKGROUND/OBJECTIVES

Transitional care management (TCM) visits delivered following hospitalization have been associated with reductions in mortality, readmissions, and total costs; however, uptake remains low. We sought to describe trends in TCM visit delivery during the COVID-19 pandemic.

DESIGN

Cross-sectional study of ambulatory electronic health records from December 30, 2019 and January 3, 2021.

SETTING

United States.

PARTICIPANTS

Forty four thousand six hundred and eighty-one patients receiving transitional care management services.

MEASUREMENTS

Weekly rates of in-person and telehealth TCM visits before COVID-19 was declared a national emergency (December 30, 2019 to March 15, 2020), during the initial pandemic period (March 16, 2020 to April 12, 2020) and later period (April 12, 2020 to January 3, 2021). Characteristics of patients receiving in-person and telehealth TCM visits were compared.

RESULTS

A total of 44,681 TCM visits occurred during the study period with the majority of patients receiving TCM visits age 65 years and older (68.0%) and female (55.0%) Prior to the COVID-19 pandemic, nearly all TCM visits were conducted in-person. In the initial pandemic, there was an immediate decline in overall TCM visits and a rise in telehealth TCM visits, accounting for 15.4% of TCM visits during this period. In the later pandemic, the average weekly number of TCM visits was 841 and 14.0% were telehealth. During the initial and later pandemic periods, 73.3% and 33.6% of COVID-19-related TCM visits were conducted by telehealth, respectively. Across periods, patterns of telehealth use for TCM visits were similar for younger and older adults.

CONCLUSION

The study findings highlight a novel and sustained shift to providing TCM services via telehealth during the COVID-19 pandemic, which may reduce barriers to accessing a high-value service for older adults during a vulnerable transition period. Further investigations comparing outcomes of in-person and telehealth TCM visits are needed to inform innovation in ambulatory post-discharge care.

Authors+Show Affiliations

Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Harvard Medical School, Boston, Massachusetts, USA.Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Harvard Medical School, Boston, Massachusetts, USA.Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Harvard Medical School, Boston, Massachusetts, USA. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34124776

Citation

Anderson, Timothy S., et al. "Trends in Telehealth and In-person Transitional Care Management Visits During the COVID-19 Pandemic." Journal of the American Geriatrics Society, vol. 69, no. 10, 2021, pp. 2745-2751.
Anderson TS, O'Donoghue AL, Dechen T, et al. Trends in telehealth and in-person transitional care management visits during the COVID-19 pandemic. J Am Geriatr Soc. 2021;69(10):2745-2751.
Anderson, T. S., O'Donoghue, A. L., Dechen, T., Herzig, S. J., & Stevens, J. P. (2021). Trends in telehealth and in-person transitional care management visits during the COVID-19 pandemic. Journal of the American Geriatrics Society, 69(10), 2745-2751. https://doi.org/10.1111/jgs.17329
Anderson TS, et al. Trends in Telehealth and In-person Transitional Care Management Visits During the COVID-19 Pandemic. J Am Geriatr Soc. 2021;69(10):2745-2751. PubMed PMID: 34124776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in telehealth and in-person transitional care management visits during the COVID-19 pandemic. AU - Anderson,Timothy S, AU - O'Donoghue,Ashley L, AU - Dechen,Tenzin, AU - Herzig,Shoshana J, AU - Stevens,Jennifer P, Y1 - 2021/06/25/ PY - 2021/06/01/revised PY - 2021/04/17/received PY - 2021/06/06/accepted PY - 2021/6/15/pubmed PY - 2021/6/15/medline PY - 2021/6/14/entrez KW - COVID-19 KW - hospitalization KW - medicare KW - transitional care management SP - 2745 EP - 2751 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 69 IS - 10 N2 - BACKGROUND/OBJECTIVES: Transitional care management (TCM) visits delivered following hospitalization have been associated with reductions in mortality, readmissions, and total costs; however, uptake remains low. We sought to describe trends in TCM visit delivery during the COVID-19 pandemic. DESIGN: Cross-sectional study of ambulatory electronic health records from December 30, 2019 and January 3, 2021. SETTING: United States. PARTICIPANTS: Forty four thousand six hundred and eighty-one patients receiving transitional care management services. MEASUREMENTS: Weekly rates of in-person and telehealth TCM visits before COVID-19 was declared a national emergency (December 30, 2019 to March 15, 2020), during the initial pandemic period (March 16, 2020 to April 12, 2020) and later period (April 12, 2020 to January 3, 2021). Characteristics of patients receiving in-person and telehealth TCM visits were compared. RESULTS: A total of 44,681 TCM visits occurred during the study period with the majority of patients receiving TCM visits age 65 years and older (68.0%) and female (55.0%) Prior to the COVID-19 pandemic, nearly all TCM visits were conducted in-person. In the initial pandemic, there was an immediate decline in overall TCM visits and a rise in telehealth TCM visits, accounting for 15.4% of TCM visits during this period. In the later pandemic, the average weekly number of TCM visits was 841 and 14.0% were telehealth. During the initial and later pandemic periods, 73.3% and 33.6% of COVID-19-related TCM visits were conducted by telehealth, respectively. Across periods, patterns of telehealth use for TCM visits were similar for younger and older adults. CONCLUSION: The study findings highlight a novel and sustained shift to providing TCM services via telehealth during the COVID-19 pandemic, which may reduce barriers to accessing a high-value service for older adults during a vulnerable transition period. Further investigations comparing outcomes of in-person and telehealth TCM visits are needed to inform innovation in ambulatory post-discharge care. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/34124776/Trends_in_telehealth_and_in_person_transitional_care_management_visits_during_the_COVID_19_pandemic_ L2 - https://doi.org/10.1111/jgs.17329 DB - PRIME DP - Unbound Medicine ER -