Healthcare utilization and telemedicine: An evaluation using linked administrative data from Manitoba

Abstract

Introduction

This research examines utilization patterns for patients using telemedicine compared to those receiving treatment conventionally. Administrative data from 2007–2016 is linked to records from the Manitoba Telehealth programme to conduct a population-level study.

Methods

Using a high dimensional propensity-weighted regression model, the study compares four utilization measures between telemedicine users and non-users. These include: ambulatory visits (number of visits to any physician), visits to primary care physicians, visits to specialists and the number of hospitalizations.

Results

Compared to non-users, telemedicine patients showed a higher number of in-person visits. Specifically, using incidence-rate ratios, telemedicine users had 1.32 more ambulatory visits (p < 0.001; 95% confidence interval, 1.23–1.41), 1.26 more visits to primary care practitioners (p<0.001; 95% confidence interval, 1.17–1.35), 1.38 more visits to specialists (p < 0.001; 95% confidence interval, 1.19–1.61) and 1.14 more hospitalizations (p>0.1; 95% confidence interval, 0.91–1.43). These results were robust to restricted analyses for distance, regions, and chronic conditions. Those patients with frequent virtual encounters with a specialist showed a decrease of the frequency of in-person visits of the same type of care (incidence-rate ratio=0.48, p < 0.001; 95% confidence interval, 0.44–0.54).

Discussion

Patterns in utilization vary between telemedicine users and non-users, with users showing a higher number of in-person visits than non-users, and only frequent users of telemedicine showing reduced in-person visits. Future investigation linking utilization patterns with patient care outcomes and costs will inform healthcare policy and clinical treatment plans.