Primary Care Practice Telehealth Use and Low-Value Care Services

作者：Terrence Liu, Ziwei Zhu, Michael P. Thompson, Jeffrey S. McCullough, Hechuan Hou, Chiang‐Hua Chang, A. Mark Fendrick, Chad Ellimoottil · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.45436 · 被引用次数：13 · 研究领域：Telemedicine and Telehealth Implementation、COVID-19 and healthcare impacts、Healthcare cost, quality, practices

Importance: The rapid expansion of telehealth transformed how primary care practices deliver care; however, uncertainties about the quality of telehealth-delivered care compared with in-person care remain. While there are concerns that increased telehealth may introduce wasteful care, how telehealth affects the delivery of low-value care is unknown. Objective: To examine whether a primary care practice's level of telehealth use is associated with changes in the rates of low-value care. Design, Setting, and Participants: This retrospective cohort study using a difference-in-differences study design was conducted from January 1, 2019, to December 31, 2022, using Medicare fee-for-service claims data. Participants were Medicare beneficiaries attributed to primary care practices in Michigan. Exposures: Low, medium, or high tertile of practice-level telehealth use. Main Outcomes and Measures: Low-value care was assessed using 8 claims-based measures relevant to primary care, grouped into 4 main categories: office-based, laboratory-based, imaging-based, and mixed-modality services. Poisson regression models were used to estimate the association between practice-level telehealth use and rates of low-value care services, controlling for practice-level characteristics. Results: A total of 577 928 beneficiaries (332 100 [57%] women; mean [SD] age, 76 [8] years) attributed to 2552 primary care practices were included in the study. After adjusting for practice-level characteristics and ba...