Adverse Event Rate Similar for Remote, In-Home Physician Visits

While researching the outcomes associated with various types of physician visits, a study published in JAMA Network Open found that the benefits of in-home physician visits did not widely differ from those associated with remote physician visits.

Although the recent growth in remote care is widely regarded as beneficial for patients and providers, questions surrounding its benefits compared to in-home care methods remain.

For the study, a group of researchers examined data from 172 patients at an academic medical center, all requiring hospital-level care for various conditions, including infection, heart failure, chronic obstructive pulmonary disease, and asthma. All data used in the study was gathered from Aug. 3, 2019, to March 26, 2020.

To measure and compare the results associated with in-home and remote care, researchers studied the number of adverse events, such as accidents and injuries, using it as the primary unit of measurement. The number of adverse events was measured using Poisson regression at a noninferiority scale of 10 events per 100 patients.

As a secondary measurement, researchers evaluated the results of the Picker Patient Experience Questionnaire 15 score along with 30-day readmission rates.

Of the 172 patients included in the study, 84 received care remotely, and 88 received in-home physician care. The patients' mean age was 69.3 years, 56.4 percent were female, 45 percent were White, and 24.4 percent lived alone.

The mean adjusted adverse event count was 6.8 per 100 patients among those receiving remote care. This was slightly higher than the count reported by the group that received in-home physician visits, which was 3.9 per 100 patients. The limited difference of 2.8 per 100 patients was insufficient in proving inferiority.

Further, the difference in mean adjusted Picker Patient Experience Questionnaire 15 scores between remote and in-home care was -0.22. The difference in 30-day readmission rates was 2.28 percent. Both secondary outcomes failed to prove significant differences between the two groups.

These results support the conclusion that remote care is non-inferior to at-home physician visits. Although there were several limitations relating to the COVID-19 pandemic, like limited site enrollment, nonresponse bias, and variable recall bias, the analysis led researchers to determine that both channels had similar levels of efficacy in patient care.

This study adds to growing evidence that telehealth and remote care have proven effective for patients with varied needs.

A study published in July found that maternal care outcomes improved following the implementation of telehealth. Researchers made this conclusion based on increased patient satisfaction and reduced anxiety levels following the integration of virtual care services.

Another study from March found that pediatric orthopedic patients who received care virtually reported high levels of satisfaction. This is related to positive results associated with video communication and audio connection.