Outpatient Management of Heart Failure During the COVID-19 Pandemic After Adoption of a Telehealth Model.
JACC Heart Fail
; 9(12): 916-924, 2021 12.
Article
en En
| MEDLINE
| ID: mdl-34857175
ABSTRACT
OBJECTIVES:
This study sought to determine whether the increased use of telehealth was associated with a difference in outcomes for outpatients with heart failure.BACKGROUND:
The COVID-19 pandemic led to dramatic changes in the delivery of outpatient care. It is unclear whether increased use of telehealth affected outcomes for outpatients with heart failure.METHODS:
In March 2020, a large Midwestern health care system, encompassing 16 cardiology clinics, 16 emergency departments, and 12 hospitals, initiated a telehealth-based model for outpatient care in the setting of the COVID-19 pandemic. A propensity-matched analysis was performed to compare outcomes between outpatients seen in-person in 2018 and 2019 and via telemedicine in 2020.RESULTS:
Among 8,263 unique patients with heart failure with 15,421 clinic visits seen from March 15 to June 15, telehealth was employed in 88.5% of 2020 visits but in none in 2018 or 2019. Despite the pandemic, more outpatients were seen in 2020 (n = 5,224) versus 2018 and 2019 (n = 5,099 per year). Using propensity matching, 4,541 telehealth visits in 2020 were compared with 4,541 in-person visits in 2018 and 2019, and groups were well matched. Mortality was similar for telehealth and in-person visits at both 30 days (0.8% vs 0.7%) and 90 days (2.9% vs 2.4%). Likewise, there was no excess in hospital encounters or need for intensive care with telehealth visits.CONCLUSIONS:
A telehealth model for outpatients with heart failure allowed for distanced encounters without increases in subsequent acute care or mortality. As the pressures of the COVID-19 pandemic abate, these data suggest that telehealth outpatient visits in patients with heart failure can be safely incorporated into clinical practice.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_sistemas_informacao_saude
Asunto principal:
Telemedicina
/
COVID-19
/
Insuficiencia Cardíaca
Límite:
Humans
Idioma:
En
Revista:
JACC Heart Fail
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos