At the commencement of COVID-19, the Veterans Health Administration (VA) experienced a rapid expansion of telehealth (video/telephone) visits to continue the delivery of primary care (PC) services. For a study, researchers sought to investigate PC-based virtual and video-based treatment’s patient, provider, and location aspects. Interrupted time series (ITS) design was undertaken using VA administrative/clinical, electronic healthcare data 12 months before and 12 months after the commencement of COVID-19 (scheduled for March we2020) at the VA Greater Los Angeles Healthcare System (GLA) between 2019 and 2021. The analysis comprised patients with at least 1 visit to a VA PC clinic at GLA (n=547,730). This study’s 2 primary outcomes were telehealth (vs. in-person care) and video-based care (versus telephone). Segmented logistic regression on repeated monthly observations of telehealth and video-based care was utilized for the ITS analysis. Telehealth and video usage surged from 13.9% to 63.1% and from 0.3% to 11.3%, respectively, before COVID-19. According to adjusted percentages, GLA community-based clinics (37.7% vs. 29.8% in hospital-based clinics, P<.001), social workers/pharmacists/dietitians (53.7% vs. 34.0% for PC clinicians, P<.001), and minority groups, non-Hispanic African Americans (36.3%) and Hispanics (34.4% vs. 35.3% for Whites, P<.001), were more likely In contrast, mental health practitioners (43.3%) were more likely than PC doctors (15.3%) and women (for all age groups except 75+) to use video rather than the telephone (all P’s<.001). Since telehealth care delivery was likely to continue after COVID-19, additional research was required to determine which PC outpatient services (e.g., case management) were best suited for telephone (as opposed to video-based) care (e.g., integrated mental health visits). In addition, it was crucial to comprehend how all clinics might systematically enhance access to both telephone- and video-based PC services while ensuring that all patient populations received equitable care.
Source – bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01738-3
