Healthcare utilization and economic analysis of an internal on-demand telehealth service for upper respiratory infections
Seyedehyasmin Moghaddamziabari, Sarah C Haynes, Patrick S Romano, Guibo Xing, Tonya P Khounani, Daniel Stein, Daniel W Black, James P MarcinIntroduction
On-demand telehealth services are available to improve access and convenience of care, with some expectation that these visits may replace scheduled video visits and in-person visits. As on-demand telehealth becomes integrated into healthcare delivery models, there is a need to evaluate its impact on access, utilization, and charges.
Objective
This study evaluates an integrated, on-demand telehealth service (Express-Care) at an academic health center and how its availability and adoption influenced healthcare utilization and charges for patients seeking care for upper respiratory tract infections (URIs).
Methods
A retrospective cohort study was conducted using electronic health record data from UC Davis Health between July 2018 and October 2024. A cohort of patients using Express-Care for URI was compared to patients receiving URI care via other modalities using a 1:2 propensity score match on sex, age, race/ethnicity, insurance, California Healthy Place Index, comorbidities, and household income. Patients who did not have URI visits both before and after the launch of Express-Care were excluded.
Results
Among the 26,605 patients treated for URI, Express-Care users were more likely to be female (66.9% vs. 61.9%,
Discussion
Access to Express-Care resulted in 42% more visits for URIs among users than among matched nonusers. Despite the increased visit frequency and follow-up rates for URIs, Express-Care was associated with lower mean healthcare charges.