Quality of care for acute respiratory infections during direct-to-consumer telemedicine visits for adults

Citation:

Shi Z, Mehrotra A, Gidengil C, Poon SJ, Uscher-Pines L, and Ray KN. 12/2018. “Quality of care for acute respiratory infections during direct-to-consumer telemedicine visits for adults.” Health Affairs , 37, 12, Pp. 2014-2023.

Abstract:

In direct-to-consumer telemedicine, physicians treat patients through real-time audiovisual conferencing for common conditions such as acuterespiratory infections. Early studies had mixed findings on the quality of care provided during direct-to-consumer telemedicine and were limited by small sample sizes and narrow geographic scopes. Using claims data for 2015-16 from a large national commercial insurer, we examined the quality of antibiotic management in adults with acute respiratory infection diagnoses at 38,839 direct-to-consumer telemedicinevisits, compared to the quality at 942,613 matched primary care visits and 186,016 matched urgent care visits. In the matched analyses, we found clinically similar rates of antibiotic use, broad-spectrum antibiotic use, and guideline-concordant antibiotic management. However, direct-to-consumer telemedicine visits had less appropriate streptococcal testing and a higher frequency of follow-up visits. These results suggest specific opportunities for improvement in direct-to-consumer telemedicine quality.
Last updated on 05/22/2019