Utility of telephone visits at an urban safety‐net hospital during 2020: A retrospective review

Abstract

Abstract Objective During COVID‐19, otolaryngology clinics rapidly implemented telehealth programs in accordance with social distancing guidelines and institutional policies. Our objectives are to evaluate the usefulness of telephone audio visits for underserved patients seeking otolaryngological care at an urban safety‐net hospital and identify patient factors associated with telephone visit attendance. Methods In a retrospective review of all adult telephone visits in 2020, we compared the demographics and visit characteristics of patients who attended telehealth versus in‐person visits and patients who attended versus missed telehealth visits. Univariable and multivariable regressions were utilized to identify predictors of missing telehealth visits. Results We identified 318 telehealth encounters completed by 254 patients (72.8% were of racial/ethnic minority; 76.3% had low‐income, need‐based insurances; 43.7% had limited English proficiency). The most common chief complaints were related to head and neck oncology (n = 85, 26.7%), otology/neurotology (n = 74, 23.3%), and general otolaryngology (n = 69, 21.7%). The following actions were executed during telephone visits: behavioral and/or medication patient education (n = 152, 47.8%); sharing testing/imaging/tumor board results (n = 125, 39.3%); referrals to another department (n = 103, 32.4%); rendering a new diagnosis (n = 98, 30.8%); changing medications (n = 60, 18.9%). Less than half of telephone visits (46.2%) resulted in in‐person follow‐up, most commonly for in‐person exams. The distribution of race/ethnicity differed between attended in‐person appointments versus telephone visits (p = .01), but race and ethnicity were not significant predictors of telephone visit attendance. Conclusion Despite limited diagnostic capabilities, telephone audio visits can be an effective and accessible tool for providing continuity and advancing care in socially disadvantaged patients. Level of evidence IV.

Keywords

• clinical otolaryngology
• health disparities
• social determinants of health
• telehealth