Health Care Visit Modality Among Older Adults: Telehealth and Subsequent Emergency Department Use

Introduction: Telehealth may address deficiencies in care provision for older adults, but potential downsides when used in place of in-person care are unclear. The use of subsequent care may be informative in a comprehensive evaluation of telehealth.Methods: We used administrative claims data from Optum's de-identified Clinformatics (R) Data Mart Database to explore telehealth use in outpatient care and subsequent emergency department (ED) utilization before and during the COVID-19 pandemic.Results: We found evidence that telehealth use is associated with a higher likelihood of subsequent ED visits within six months relative to in-person care, but estimated differences vary across years and by age group. In 2021, estimated differences are statistically significant and increasing by age group.Conclusion: Telehealth may be associated with more frequent subsequent use of ED care compared with in-person care; however, more work is needed to understand healthcare quality differentials by visit modality and whether the results are causal.