107. Telemedicine Does Not impact the Number of Emergency Room Visits or Hospitalizations in Pediatric Neurosurgical Patients

Authors: Jennifer Sachiko Ronecker, MD

The COVID-19 pandemic has brought new challenges to medicine. To reduce the number of patients and caregivers evaluated in-person, we began seeing patients via telemedicine. Providers determined which patients could be seen via telemedicine or an in-person visit. We hypothesized that there would be no significant difference in the number of emergency department (ED) visits or hospitalizations between patients seen via telemedicine or in-person.Methods: The number of patients evaluated in the neurosurgery clinic between May 2020 and April 2021 was collected, as well as the number of patients who present to the hospital within 45 days. The senior author then reviewed each of those patients’ records to determine whether the chief complaint was addressed during that clinic visit. Patients who were sent to the ED immediately after the visit were counted separately. T-tests were performed to determine the statistical significance of the monthly rate of admissions and ED visits following the clinic visit.
There was a total of 5509 clinic visits, with 52.4% in person and 47.6% telemedicine. After in-person visits, 0.17% of patients were sent directly to the ED after clinic, and 0.07% of patients presented to the hospital within 45 days. In contrast, for telemedicine visits, 0.15% were sent to the ED for further evaluation and 0.11% presented to the hospital within 45 days. There was no significant difference in the number of patients who were sent to the ED on telemedicine or in person (p=0.92) and for those who presented within 45 days (p=0.66).
Telemedicine visits did not result in an increased burden to the hospital or caregivers in terms of ED utilization and hospital admissions. Telemedicine visits are a safe, effective means by which to evaluate pediatric neurosurgical patients from home while avoiding possible risk of COVID exposure in the clinic setting.