No-Show Rates in a Perinatal Practice: Telemedicine Compared With In-Person Visits [ID 2683494

Abstract

INTRODUCTION: The objective of this study was to determine the effect of telemedicine on no-show rates in a perinatal practice before, during, and after the COVID-19 pandemic. METHODS: A retrospective study was conducted among pregnant patients receiving care at a private maternal–fetal medicine (MFM) practice in New Mexico from January 2020 to June 2023. The primary outcome was attendance for telemedicine versus in-person visit evaluated by visit type including MFM consultation, diabetes management, and mental health. RESULTS: Maternal–fetal medicine visits showed no difference in no-show rates between telemedicine versus in-person visits for 2020, 2022, and 2023. More no-show visits occurred in 2021 with 118/1,800 (6.56%) for telemedicine versus 632/15,608 (4.05%) for in-person visits (P<.0001) and for all years combined with 352/7,144 (4.93%) for telemedicine versus 1,952/49,363 (3.95%) for in-person visits (P=.0001). The odds ratio for no-show visits for all years was 1.26 (1.12, 1.41) for telemedicine versus in-person visits. Diabetes management visits showed higher no-show rates for telemedicine versus in-person visits each year and overall. For all years combined, more diabetes management no-show visits (1,454/12,232 [11.89%]) occurred for telemedicine versus 15/310 (4.84%) for in-person visits with an odds ratio for telemedicine no-show visits of 2.65 (1.57, 4.47) (P=.002). For all years combined, fewer mental health no-show visits (362/1,823 [19.86%]) occurred for telemedicine versus 76/224 (33.93%) for in-person visits with an odds ratio for telemedicine no-show visits of 0.48 [0.36, 0.65] (P<.001). CONCLUSION: Telemedicine use expanded greatly during the COVID-19 pandemic in all areas of health care including maternal–fetal medicine. In this large private practice-based cohort, different outcomes were noted in areas unique to perinatal care. Patients undergoing MFM consultation with ultrasound had comparably low no-show rates for telemedicine versus in-person visits. Opposite effects were noted for diabetes management and mental health visits with higher no-show rates for telemedicine diabetes management visits and lower no-show rates for telemedicine mental health visits.