Using Virtual Visits to Care for Primary Care Patients With COVID-19 Symptoms

Derjung M. Tarn; Courtney Hintz; Eluar Mendez-Hernandez; Sabrina P. Sawlani; Michelle A. Bholat

doi:10.3122/jabfm.2021.S1.200241

Article Figures & Data

Figures

Tables

Download figure
Open in new tab
Figure 1.
Distribution of initial and follow-up visits. Abbreviations: ED, emergency department.

Tables

Figures

View popup

Table 1.

Patient Characteristics, Overall and by Visit Type

Characteristic	All Patients, n = 202	Telehealth, n = 89	Telephone, n = 55	In Person, n = 52	p-Value
Female, n (%)	120 (59.4)	57 (64)	39 (70.9)	22 (42.3)	0.006
Age, mean (SD; range)	36.8 (19.5; 1 to 89)	40.3 (14.7; 4 to 73)	40.7 (22; 1 to 89)	26.4 (20; 1 to 72)	<0.001
Race/ethnicity, n (%)^*					0.3
Asian	19 (9.4)	10 (11.2)	5 (9.1)	4 (7.7)
Black	15 (7.4)	6 (6.7)	5 (9.1)	4 (7.7)
Hispanic	28 (13.9)	15 (16.9)	11 (20)	2 (3.8)
Other	23 (11.4)	8 (9)	4 (7.3)	9 (17.3)
White	93 (46)	37 (41.6)	23 (41.8)	29 (55.8)
Unknown	24 (11.9)	13 (14.6)	7 (12.7)	4 (7.7)
Married, n (%)	60 (29.7)	32 (36)	18 (32.7)	8 (15.4)	0.03
Insurance, n (%)					0.001
PPO	74 (36.6)	35 (39.3)	19 (34.5)	18 (34.6)
HMO	66 (32.7)	38 (42.7)	16 (29.1)	10 (19.2)
Medicaid	42 (20.8)	10 (11.2)	10 (18.2)	20 (38.5)
Medicare	12 (5.9)	2 (2.3)	7 (12.7)	3 (5.8)
Other	8 (4.0)	4 (4.5)	3 (5.5)	1 (1.9)
Preferred language-English, n (%)	192 (95.1)	86 (96.6)	51 (92.7)	49 (94.3)	0.57
Comorbidity score, mean (S.D.)^*	0.22 (0.6)	0.19 (0.5)	0.4 (0.89)	0.08 (0.33)	0.02
Asthma, n (%)	23 (11.4)	14 (15.7)	5 (9.1)	4 (7.7)	0.28
Hypertension, n (%)	25 (12.4)	10 (11.2)	11 (20)	2 (3.9)	0.03
Anxiety disorder, n (%)	57 (28.2)	29 (32.6)	16 (29.1)	10 (19.2)	0.23
Body mass index, mean (SD)^†	26.6 (5.9)	26.4 (5.5)	27.4 (6.3)	25.5 (6.8)	0.40
Current or previous smoking, n (%)	20 (9.9)	10 (11.2)	10 (18.2)	0	0.10
# total interactions with office, mean (SD; range)	5.34 (3.5; 2 to 20)	6.07 (3.7; 2 to 20)	5.16 (3.6; 2 to 18)	4.52 (3.0; 2 to 17)	0.03
Telephone calls	4.39 (2.6; 1 to 12)	4.39 (2.5; 1 to 12)	5.29 (2.6; 2 to 12)	3.56 (2.46; 1 to 12)	0.002
E-mail messages	1.70 (1.2; 1 to 8)	1.97 (1.3; 1 to 6)	1.58 (1.29; 1 to 8)	1.40 (0.96; 1 to 7)	0.02
Telemedicine	1.64 (0.80; 1 to 6)	2.30 (0.70; 1 to 6)	1.16 (0.46; 1 to 3)	1.10 (0.30; 1 to 2)	<0.001
In person	1.36 (0.64; 1 to 4)	1.06 (0.23; 1 to 2)	1.04 (0.19; 1 to 2)	2.25 (0.62; 1 to 4)	<0.001
Outpatient testing, n (%)
COVID-19	40 (19.8)	22 (24.7)	13 (23.6)	5 (9.6)	0.16
Influenza	17 (8.4)	6 (6.7)	1 (1.8)	10 (19.2)	0.004
Streptococcus	2 (1.0)	1 (1.1)	0	1 (1.9)	0.61
Chest radiograph	15 (7.4)	5 (5.6)	4 (7.3)	6 (11.5)	0.44
Antibiotics prescribed, n (%)	35 (17.3)	11 (12.4)	6 (10.9)	18 (34.6)	0.001
Bronchodilator prescribed, n (%)	32 (15.8)	15 (16.9)	7 (12.7)	10 (19.2)	0.65
Patient-reported symptoms, n (%)
Fever	79 (39.1)	33 (37.1)	20 (36.4)	25 (48.1)	0.36
Cough	158 (78.2)	75 (84.3)	38 (69.1)	41 (78.9)	0.10
Shortness of breath	77 (38.1)	43 (48.3)	20 (36.4)	11 (21.2)	0.01

↵* Charlson comorbidity index⁶; scores range from 0 to 13 with higher numbers indicating greater comorbidity.
† Among adults only; n = 162.
PPO, Preferred Provider Organization; HMO, Health Maintenance Organization; SD, standard deviation.