Telemedicine visits for pediatric primary care were associated with approximately 10% to 12% lower rates of medication prescribing compared with in-person visits, according to a recent study.
The cohort study examined health care utilization outcomes associated with telemedicine versus in-person visits in pediatric primary care. The study analyzed 782,596 appointments among 438,638 patients younger than 18 years within the Kaiser Permanente Northern California health system during 2022. Of total appointments, telemedicine accounted for 42.4% (143,960 video visits [18.4%] and 188,193 telephone visits [24.0%]).
Telemedicine visits were associated with significantly lower rates of medication prescribing and diagnostic orders compared with in-person visits. Medication prescribing occurred in 39.8% of in-person visits, compared with 29.5% of video visits (adjusted difference, −10.3%; 95% confidence interval [CI], −10.6% to −10.0%) and 27.3% of telephone visits (adjusted difference, −12.5%; 95% CI, −12.7% to −12.5%). Laboratory orders were more frequent in in-person visits (24.6%) than in video (7.8%; adjusted difference, −16.8%; 95% CI, −17.0% to −16.6%) or telephone visits (8.5%; adjusted difference, −16.2%; 95% CI, −16.3% to −16.0%). Imaging orders followed a similar pattern.
In-person follow-up visits within 7 days were more frequent following telemedicine appointments (14.4% for video visits; 15.1% for telephone visits) than in-person visits (4.3%). Nearly half of these follow-up visits after telemedicine (49.2% for telephone and 47.3% for video) occurred within the first 24 hours. Emergency department (ED) visits were slightly higher after telemedicine (2.04% for video; 2.00% for telephone) than in-person visits (1.75%). Hospitalization rates were similar across visit types, with 0.14% after in-person visits, 0.12% after video visits (adjusted difference, -0.02%; 95% CI -0.04% to 0.00%), and 0.08% after telephone visits (adjusted difference, -0.02%; 95% CI, -0.07 to -0.04%).
These findings, published in JAMA Health Forum, indicate that telemedicine is associated with reduced prescribing and diagnostic orders, modestly increased follow-up and ED visits, and similar hospitalization rates compared with in-person care. Additional research is required to evaluate the effectiveness of telemedicine in pediatric primary care, particularly in measuring variations in downstream follow-up care needs.
Full disclosures can be found in the published study.
