Table 2.
Relative changes in medical costs and health care utilization among individuals with HD among telehealth users and telehealth nonusers (adjusted).a
| Variables | Total costs, $ | No. of ED visits | No. of inpatient admissions | No. of pharmacy prescriptions | Average no. of days of drug supply | ED visit costs, $ | Inpatient admission costs, $ | Outpatient costs, $ | Pharmacy costs, $ |
|---|---|---|---|---|---|---|---|---|---|
| Diff-in-diff | −1814*** (−2732 to −895.8) | −0.0886*** (−0.110 to −0.0675) | −0.0324*** (−0.0396 to −0.0252) | 0.514** (0.126-0.903) | 0.773*** (0.406-1.139) | −208.8*** (−272.0 to −145.6) | −1574*** (−2062 to −1085) | −815.8* (−1448 to −183.3) | 838.1*** (520.3 to 1156) |
| Mean telehealth nonusers prea | $10 976 | 0.392 | 0.101 | 11.34 | 24.96 | $724.4 | $3939 | $3928 | $1865 |
| Mean telehealth users preb | $17 224 | 0.548 | 0.130 | 19.50 | 26.31 | $1148 | $5493 | $5621 | $4243 |
| Diff—prec | $6248 | 0.157 | 0.0293 | 8.165 | 1.350 | $423.8 | $1554 | $1693 | $2379 |
| Mean telehealth nonusers posta | $11 301 | 0.324 | 0.0836 | 10.82 | 27.74 | $583.8 | $3534 | $4253 | $2360 |
| Mean telehealth users postb | $15 735 | 0.392 | 0.0804 | 19.50 | 29.87 | $798.8 | $3514 | $5130 | $5577 |
| Diff—postc | $4434 | 0.0680 | −0.00314d | 8.680 | 2.123 | $215 | −$19.98 | $877 | $3217 |
Abbreviations: diff-in-diff, difference-in-differences estimates; ED, emergency department; HD, heart disease.
Of the 70 041 individuals with HD (Appendix Figure S1), 21 598 (30.8%) individuals had any telehealth during the stay-at-home order periods. All estimates came from difference-in-differences models, adjusted for age group, sex, urban/rural, census region of individuals’ place of residence, COVID-19 infection status during the stay-at-home order and subsequent periods, number of in-person outpatient visits during the stay-at-home order period, and comorbidities. The difference-in-differences estimates are the differences in means between telehealth users and telehealth nonusers in the pre– and post–stay-at-home order periods. 95% CIs are in parentheses. All estimates are per patient per year. All of the original coefficients from the difference-in-difference models are shown in Appendix Table S7. ***P < .001; **P < .01; *P < .05.
aMean telehealth nonusers pre/post indicates the average of outcomes in the pre– and post–stay-at-home order period (March–June 2020) among telehealth nonusers.
bMean telehealth users pre/post indicates the average of outcomes in the pre– and post–stay-at-home order period among telehealth users.
cDiff—pre/post indicates the differences in the average of outcomes between telehealth users and telehealth nonusers in pre– and post–telehealth use during the stay-at-home order periods.
dNegative average values are adjusted averages of the outcomes after controlling for the list of control variables. Unadjusted estimates are all positive and available in Appendix Table S5.