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Health care utilization following "digi-physical" assessment compared to physical assessment for infectious symptoms in primary care

Entezarjou, Artin LU orcid ; Sjöbeck, Maria LU ; Midlöv, Patrik LU orcid ; Nymberg, Veronica Milos LU ; Vigren, Lina LU ; Labaf, Ashkan LU ; Jakobsson, Ulf LU orcid and Calling, Susanna LU (2022) In BMC Primary Care 23.
Abstract

Background: The use of chat-based digital visits (eVisits) to assess infectious symptoms in primary care is rapidly increasing. The "digi-physical" model of care uses eVisits as the first line of assessment while assuming a certain proportion of patients will inevitably need to be further assessed through urgent physical examination within 48 h. It is unclear to what extent this approach can mitigate physical visits compared to assessing patients directly using office visits.

Methods: This pre-COVID-19-pandemic observational study followed up "digi-physical" eVisit patients (n = 1188) compared to office visit patients (n = 599) with respiratory or urinary symptoms. Index visits occurred between March 30th 2016 and March 29th 2019.... (More)

Background: The use of chat-based digital visits (eVisits) to assess infectious symptoms in primary care is rapidly increasing. The "digi-physical" model of care uses eVisits as the first line of assessment while assuming a certain proportion of patients will inevitably need to be further assessed through urgent physical examination within 48 h. It is unclear to what extent this approach can mitigate physical visits compared to assessing patients directly using office visits.

Methods: This pre-COVID-19-pandemic observational study followed up "digi-physical" eVisit patients (n = 1188) compared to office visit patients (n = 599) with respiratory or urinary symptoms. Index visits occurred between March 30th 2016 and March 29th 2019. The primary outcome was subsequent physical visits to physicians within two weeks using registry data from Skåne county, Sweden (Region Skånes Vårddatabas, RSVD).

Results: No significant differences in subsequent physical visits within two weeks (excluding the first 48 h) were noted following "digi-physical" care compared to office visits (179 (18.0%) vs. 102 (17.6%), P = .854). As part of the "digital-physical" concept, a significantly larger proportion of eVisit patients had a physical visit within 48 h compared to corresponding office visit patients (191 (16.1%) vs. 19 (3.2%), P < .001), with 150 (78.5%) of these eVisit patients recommended some form of follow-up by the eVisit physician.

Conclusions: Most eVisit patients (68.9%) with respiratory and urinary symptoms have no subsequent physical visits. Beyond an unavoidable portion of patients requiring urgent physical examination within 48 h, "digi-physical" management of respiratory and urinary symptoms results in comparable subsequent health care utilization compared to office visits. eVisit providers may need to optimize use of resources to minimize the proportion of patients being assessed both digitally and physically within 48 h as part of the "digi-physical" concept.

Trial registration: Clinicaltrials.gov identifier: NCT03474887.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12875-021-01618-2.

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organization
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type
Contribution to journal
publication status
published
subject
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BMC Primary Care
volume
23
article number
4
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85122951978
  • pmid:35036998
ISSN
2731-4553
DOI
10.1186/s12875-021-01618-2
language
English
LU publication?
yes
additional info
© The Author(s) 2022.
id
8dca129c-d072-4241-acb6-6212b7ef9306
date added to LUP
2022-01-20 10:33:14
date last changed
2024-04-18 05:14:13
@article{8dca129c-d072-4241-acb6-6212b7ef9306,
  abstract     = {{<p>Background: The use of chat-based digital visits (eVisits) to assess infectious symptoms in primary care is rapidly increasing. The "digi-physical" model of care uses eVisits as the first line of assessment while assuming a certain proportion of patients will inevitably need to be further assessed through urgent physical examination within 48 h. It is unclear to what extent this approach can mitigate physical visits compared to assessing patients directly using office visits.</p><p>Methods: This pre-COVID-19-pandemic observational study followed up "digi-physical" eVisit patients (n = 1188) compared to office visit patients (n = 599) with respiratory or urinary symptoms. Index visits occurred between March 30th 2016 and March 29th 2019. The primary outcome was subsequent physical visits to physicians within two weeks using registry data from Skåne county, Sweden (Region Skånes Vårddatabas, RSVD).</p><p>Results: No significant differences in subsequent physical visits within two weeks (excluding the first 48 h) were noted following "digi-physical" care compared to office visits (179 (18.0%) vs. 102 (17.6%), P = .854). As part of the "digital-physical" concept, a significantly larger proportion of eVisit patients had a physical visit within 48 h compared to corresponding office visit patients (191 (16.1%) vs. 19 (3.2%), P &lt; .001), with 150 (78.5%) of these eVisit patients recommended some form of follow-up by the eVisit physician.</p><p>Conclusions: Most eVisit patients (68.9%) with respiratory and urinary symptoms have no subsequent physical visits. Beyond an unavoidable portion of patients requiring urgent physical examination within 48 h, "digi-physical" management of respiratory and urinary symptoms results in comparable subsequent health care utilization compared to office visits. eVisit providers may need to optimize use of resources to minimize the proportion of patients being assessed both digitally and physically within 48 h as part of the "digi-physical" concept.</p><p>Trial registration: Clinicaltrials.gov identifier: NCT03474887.</p><p>Supplementary Information: The online version contains supplementary material available at 10.1186/s12875-021-01618-2.</p>}},
  author       = {{Entezarjou, Artin and Sjöbeck, Maria and Midlöv, Patrik and Nymberg, Veronica Milos and Vigren, Lina and Labaf, Ashkan and Jakobsson, Ulf and Calling, Susanna}},
  issn         = {{2731-4553}},
  language     = {{eng}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Primary Care}},
  title        = {{Health care utilization following "digi-physical" assessment compared to physical assessment for infectious symptoms in primary care}},
  url          = {{http://dx.doi.org/10.1186/s12875-021-01618-2}},
  doi          = {{10.1186/s12875-021-01618-2}},
  volume       = {{23}},
  year         = {{2022}},
}