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Table 2 Risk-Adjusted Occurrence of Unplanned Events and Medicare Payments per Month

From: Use telehealth as needed: telehealth substitutes in-person primary care and associates with the changes in unplanned events and follow-up visits

 

Patient-Month Records (N = 338,872)

No Visits

(N = 61,548)

Telehealth Only

(N = 61,235)

In-person Only

(N = 101,695)

Both Types

(N = 114,394)

Prob (ED = 1) per month (%)

 Baseline

2.02 (1.87, 2.17)

2.21 (2.06, 2.37)

2.32 (2.20, 2.45)

3.50 (3.37, 3.64)

 Study Period

0.77 (0.65, 0.88)

1.23 (1.10, 1.37)

2.01 (1.87, 2.15)

3.52 (3.36, 3.68)

 Difference

-1.25 (-1.52, -0.99) a

-0.98 (-1.27, -0.69) a

-0.31 (-0.58, -0.05) a

0.02 (-0.28, 0.3)

# of ED per 1,000 patients per month

 Baseline

22.5 (20.8, 24.3)

24.6 (22.8, 26.4)

26.1 (24.5, 27.6)

40.1 (38.4, 41.7)

 Study Period

8.2 (6.9, 9.5)

13.2 (11.6, 14.7)

21.9 (20.3, 23.5)

41.8 (39.6, 43.9)

 Difference

-14.3 (-17.4, -11.3) a

-11.4 (-14.8, -8.1) a

-4.2 (-7.3, -1) a

1.7 (-2.1, 5.5)

Prob (Hospitalization = 1) per month (%)

 Baseline

0.98 (0.88, 1.10)

1.14 (1.03, 1.25)

1.13 (1.04, 1.22)

1.55 (1.46, 1.63)

 Study Period

0.46 (0.37, 0.55)

0.69 (0.58, 0.79)

1.03 (0.92, 1.13)

1.87 (1.78, 1.99)

 Difference

-0.52 (-0.73, -0.33) b

-0.45 (-0.67, -0.24) a

-0.1 (-0.3, 0.09)

0.32 (0.15, 0.53) b

# of Hospitalization per 1,000 patients per month

 Baseline

11.0 (9.7, 12.3)

12.7 (11.4, 14.0)

12.9 (11.7, 14.1)

17.8 (16.8, 18.9)

 Study Period

5.5 (4.3, 6.7)

8.1 (6.7, 9.4)

12.3 (10.9, 13.7)

23.0 (21.4, 24.6)

 Difference

-5.5 (-8, -3) a

-4.6 (-7.3, -2) a

-0.6 (-3.2, 2)

5.2 (2.5, 7.8) a

$ Unplanned payment per patient per month

 Baseline

4772 (4283, 5260)

7326 (6590, 8062)

7184 (6467, 7901)

13,449 (12,167, 14,731)

 Study Period

1896 (1700, 2092)

3778 (3393, 4163)

4838 (4350, 5325)

12,588 (11,365, 13,790)

 Difference

-2876 (-3560, -2191) a

-3548 (-4669, -2427) a

-2346 (-3551, -1142) a

-861 (-3366, 1623)

  1. 95% confidence interval in parentheses. a99%, b95% significant level
  2. Entries are predicted occurrence of unplanned events (Emergency Department (ED) visits and hospitalization) and Medicare payment after risk adjustment of patient characteristics and month fixed effects. Occurrence of ED visits (or hospitalization) were measured by the average probability of having at least 1 ED visits (or hospitalizations) per patient per month and the average number of ED visits (or hospitalizations) per 1,000 patients per month. Medicare payment was measured by the average dollar amount per patient per month. Patient characteristics included age category (65–74 yrs., 75–85 yrs. or 86 + yrs.), sex, race/ethnicity (non-Hispanic White or Others), Medicaid coverage (0/1), disability entitlement (0/1), rural/urban residence (urban, suburban, large town, or small town/isolated rural), Hierarchical Condition Category (HCC) score and having 3 or more chronic conditions (0/1)