\n<\/figcaption><\/figure>\n The retrospective multicenter cohort study included 10,428 virtual and 36,767 in-person adult patients from three academic medical centers and used data spanning September 2020 to December 2021 from the <\/b>Vizient Clinical Data Base and Clinical Practice Solutions Center database. After considering <\/b>demographics, clinical characteristics, time period and prior health care utilization, patients were propensity score-matched 1:1 to result in 8,202 patients per group.<\/p>\n
Hill and colleagues analyzed both overall outcomes, further stratifying these outcomes among chief neurologic complaint and institution. They compared rates of follow-up care with the neurologic clinic, ED visits and hospitalizations.<\/p>\n
\u201cIn general, we found that neurologic patients with an initial virtual visit did not need sooner follow-up in clinic and were not more likely to go to the ED or be hospitalized compared to neurologic patients who were evaluated in-person,\u201d Hill said. \u201cWe did find some differences in subsequent care after initial visit by diagnosis.\u201d <\/p>\n
The researchers found that there was no significant difference between virtual and in-person visits within 90 days (24.6% vs. 23.7%). While there was a significant difference in 30-day follow-up (virtual, 7.3% vs. in-person, 8.4%; P = .01), the study noted no significant difference in follow-up at 6 months (42.1% vs. 41.8%) and 1 year (52.4% vs. 51.2%). <\/p>\n
When analyzing by chief complaint, the researchers noted \u201cthere was no difference in subsequent care utilization between virtual and in-person cohorts at 90 days and 30 days\u201d for most. <\/p>\n
They did find, however, that in-person visits were increased at 90 days for dementia visits (24.3% vs. virtual, 14.2%; P < .01), <\/b>and virtual visits saw an increase at 30 and 90 days for Parkinson\u2019s disease (30 days, 8.6% vs. in-person, 1.9%; 90 days, 42.4% vs. in-person, 26.7%; P<\/i> < .01 for both) and MS (30 days, 20.5% vs. in-person, 8.3%; 90 days, 45.5% vs. 23.1%; P<\/i> < .01 for both), as well as at 90 days for headache (24% vs. in-person, 18.4%; P<\/i> < .01). <\/p>\n
The study further noted neurologic hospitalizations were higher at 90 days in those who experienced stroke (4.1% vs. in-person, 1.2%; P<\/i> = .02).<\/p>\n
The researchers reported that patients with virtual and in-person visits had similar proportions of neurologic ED visits (0.9% vs. 0.8%) and hospitalizations (1.8% vs. 1.7%) within 90 days, which was also found to be true when assessing all-cause ED visits (1.8% vs. 1.7%) and hospitalizations (2.2% vs. 1.8%) within the same time period.<\/p>\n
The researchers noted more tests among patients with certain chief complaints who had an initial in-person visit, including with epilepsy, sleep disorders, PD, headache and stroke, adding a reason for this finding was unknown.<\/p>\n
Overall, Hill told Healio an initial virtual evaluation is \u201ceffective and safe\u201d for most neurologic patients.<\/p>\n
\u201cVirtual visits in this context do not lead to more testing ordered and do not result in a need for sooner in-person evaluation,\u201d Hill said. \u201cWe would like to repeat this study with more recent data, to further evaluate difference between diagnoses and for more detailed assessment of indicators of high-quality care.\u201d<\/p>\n
For more information:<\/h2>\n Chloe E. Hill<\/b>, MD, MS,\u00a0<\/b>can be reached at chloehi@med.umich.edu.<\/p>\n\n
\n
\n
<\/p>\n
Ask a clinical question<\/strong> and tap into Healio AI’s knowledge<\/strong> base.<\/p>\n\nPubMed, enrolling\/recruiting trials, guidelines<\/li>\n Clinical Guidance, Healio CME, FDA news<\/li>\n Healio’s exclusive daily news coverage of clinical data<\/li>\n<\/ul>\nLearn more<\/button>\n<\/div>\n<\/div>\n