Abstract

Inflammatory Bowel Disease Hospitalizations are Similar for Patients Receiving Tele-Visit Delivered Outpatient Care and Those Receiving Traditional In-Person Care

Am J Gastroenterol. 2024 Feb 5. doi: 10.14309/ajg.0000000000002703. Online ahead of print.

 

Shirley Cohen-Mekelburg 1 2 3Autumn Valicevic 1Lewei Lin 1 3 4Sameer D Saini 1 2 3Hyungjin Myra Kim 1 5Megan A Adams 1 2 3

 
     

Author information

1VA Center for Clinical Management Research, Ann Arbor, MI.

2Division of Gastroenterology & Hepatology, University of Michigan, Ann Arbor, MI.

3Institute for Health Policy & Innovation, Ann Arbor, MI.

4Department of Psychiatry, University of Michigan, Ann Arbor, MI.

5Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, MI 48105.

Abstract

Objectives: The COVID-19 pandemic resulted in widespread expansion of telehealth. However, there are concerns that telehealth-delivered outpatient care may limit opportunities for managing complications and preventing hospitalizations for patients with inflammatory bowel disease (IBD). We aimed to assess the association between outpatient IBD care delivered via tele-visit (video or phone) and IBD-related hospitalizations.

Methods: We conducted a case-control study of patients with IBD who had an IBD-related index hospitalization between April 2021-July 2022 and received their care in the Veterans Health Administration. We matched these hospitalized patients to controls who were not hospitalized based on age, sex, race, Charlson comorbidity index, IBD type, IBD-related emergency department use, IBD-related hospitalizations, and outpatient gastroenterology visits in the preceding year. The variable of interest was the percentage of total clinic visits delivered via tele-visit in the year prior to the index hospitalization. We compared risk of IBD-related hospitalization by exposure to tele-visit delivered care using conditional logistic regression.

Results: We identified 534 patients with an IBD-related hospitalization and 534 matched controls without an IBD-related hospitalization during the study period. Patients with IBD with a higher percentage of tele-visit delivered (vs in-person) outpatient care were less likely to be hospitalized during the study period (for every 10% increase in tele-visit use, odds ratio 0.97, 95% confidence interval 0.94-1.00;p=0.03).

Conclusions: Tele-visit delivered outpatient IBD care is not associated with higher risk of IBD-related hospitalization. These findings may reassure clinicians that tele-visit-delivered outpatient care is appropriate for patients with complex chronic diseases such as IBD.

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