Telemedicine Associated with Decreased No-Show Visits among Surgical Specialties

Abstract

INTRODUCTION: Telemedicine provides patients with a convenient method of communication with providers. However, little is known about accessibility of telemedicine among surgical patients. We aimed to assess the association of telemedicine use with patient no-show visits. METHODS: Clinic data from 7 surgical clinics at an academic medical center were reviewed (January 2018 to December 2021). A historical control (January 2018 to March 2020, in-person visits), contemporary control (March 2020 to December 2021, in-person visits), and case cohort (March 2020 to December 2021, telemedicine visits) were compared for no-show visits using ANOVA and multivariable logistic regression. RESULTS: There were 553,475 visits, of which 11.3% were no-show. Most visits were in the historical control (54.1%) compared with contemporary control (41.5%) and case visits (4.4%). No-show visits were most frequent among in-person (11.7%) compared with telemedicine visits (2.5%, p < 0.001). On logistic regression, no-show visits were more common among male (adjusted odds ratio [aOR] 1.12, 95% CI 1.09 to 1.15) patients, Black (aOR 1.68, 95% CI 1.64 to 1.73) and Asian (aOR 1.32, 95% CI 1.21 to 1.44, ref: White) patients, patients insured with Medicaid (OR 2.0, 95% CI 1.94 to 2.06, ref: Private), patients from counties with higher Social Vulnerability Index (OR 1.13, 95% CI 1.06 to 1.21), and Friday visits (OR 1.15, 95% CI 1.1 to 1.2, ref: Monday). No-show visits were less common among older patients (OR 0.98, 95% CI 0.98 to 0.98), those insured with Medicare (OR 0.83, 95% CI 0.76 to 0.91), and telemedicine visits (OR 0.21, 95% CI 0.19 to 0.24) and contemporary control (OR 0.93, 95% CI 0.91 to 0.95, ref: retrospective control) cohorts (Figure).FigureCONCLUSION: Telemedicine is associated with 79% reduction in odds of no-show visits, which are more frequent among historically vulnerable populations. Telemedicine’s convenience may serve as an intervention to improve health equity and access.