Disclosures: David R. Schulze, DO, MS:

Objective: The COVID-19 pandemic has led to an increased use of telephone visits in medical practice (CDC 2020 report). As this is a relatively newer practice the current research on the differences between in-person versus telephone visits is limited. It is important that we find out if there are differences, what those differences are, and how they are affecting patient care. This study aims to identify the differences in referral patterns to neurosurgery referrals between in-person and telephone visits among patients with lower back pain.

Design: Retrospective Cohort StudySetting : Outpatient Physical Medicine and Rehab VA ClinicParticipants : 1322 Veterans

Interventions: Intervention not applicable

Main Outcome Measures: This study compared the difference between in-person and telephone visits in the following areas: percentage of patients referred to neurosurgery by their follow-up visit and the percentage of patients that were referred for imaging at their initial visit.

Results: 1332 subjects were selected, yet only new evaluations were included in analyses. The final sample size (N) was 427 in-person and 115 phone visits for a total of 542 patients. There was a statistically significant increase in the percentage of patients referred to neurosurgery when the initial consult was via telephone (in-person [3.04%] vs telephone [12.17%]); chi square value of 15.953 and p value of .000065). Yet, there was not a significant difference in the percentage of those who received imaging (in-person [28.81%] vs telephone [25.22%]) visits; chi square value of .578 and p value of .447)Conclusions: These results show that there are significant differences between in-person visits vs telephone visits, especially when it comes to consults placed to neurosurgery. While there could a number of reasons behind this finding, including the benefits of a physical exam when determining the severity of a condition, further data is needed to clarify the impact that this has both on patients and the healthcare system.

Level of Evidence: Level III

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/telemedicine-practice-and-its-influence-on-neurosurgery-referrals-among-patients-with-low-back-pain/