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

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 ( < 0.001; 95% confidence interval, 1.23-1.41), 1.26 more visits to primary care practitioners (<0.001; 95% confidence interval, 1.17-1.35), 1.38 more visits to specialists ( < 0.001; 95% confidence interval, 1.19-1.61) and 1.14 more hospitalizations (>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,  < 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.