Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics

Hemen N. Saifu, Steven M. Asch, Matthew Bidwell Goetz, Jason P. Smith, Christopher J. Graber, Dennis Schaberg, Benjamin Sun

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Geographical barriers to subspecialty care may prevent optimal care of patients living in rural areas. We assess the impact of human immunodeficiency virus (HIV) and hepatitis C telemedicine consultation on patient-oriented outcomes in a rural Veterans Affairs population. Methods: This was a pre- and post-intervention study comparing telemedicine with in-person subspecialty clinic visits for HIV and hepatitis C. Eligible patients resided in 2 rural catchment areas. The primary binary outcome was clinic completion. We estimated a logistic regression model with patient-level fixed effects. This approach controls for the clustering of visits by patient, uses each patient's in-person clinic experience as an internal control group, and eliminates confounding by person-level factors. We also surveyed patients to assess satisfaction and patient-perceived reductions in health visit-related time. Results: There were 43 patients who accounted for 94 telemedicine visits and 128 in-person visits. Clinic completion rates were higher for telemedicine (76%) than for in-person visits (61%). In regression analyses, telemedicine was strongly predictive of clinic completion (OR 2.2; 95% confidence interval [CI]: 1.0-4.7). The adjusted effect of telemedicine on clinic completion rate was 13% (95% CI: 12-13). Of the 30 patients (70%) who completed the survey, more than 95% rated telemedicine at the highest level of satisfaction and preferred telemedicine to in-person clinic visits. Patients reported a significant reduction in health visit-related time (median 340 minutes, interquartile range 250-440), mostly due to decreased travel time. Conclusions: HIV and hepatitis C telemedicine clinics are associated with improved access, high patient satisfaction, and reduction in health visit-related time.

Original languageEnglish (US)
Pages (from-to)207-212
Number of pages6
JournalAmerican Journal of Managed Care
Volume18
Issue number4
StatePublished - Apr 2012

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Telemedicine
Hepatitis C
HIV
Ambulatory Care
Patient Satisfaction
Health
Logistic Models
Confidence Intervals
Veterans
Cluster Analysis
Patient Care
Referral and Consultation
Regression Analysis
Control Groups

ASJC Scopus subject areas

  • Health Policy

Cite this

Saifu, H. N., Asch, S. M., Goetz, M. B., Smith, J. P., Graber, C. J., Schaberg, D., & Sun, B. (2012). Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics. American Journal of Managed Care, 18(4), 207-212.

Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics. / Saifu, Hemen N.; Asch, Steven M.; Goetz, Matthew Bidwell; Smith, Jason P.; Graber, Christopher J.; Schaberg, Dennis; Sun, Benjamin.

In: American Journal of Managed Care, Vol. 18, No. 4, 04.2012, p. 207-212.

Research output: Contribution to journalArticle

Saifu, HN, Asch, SM, Goetz, MB, Smith, JP, Graber, CJ, Schaberg, D & Sun, B 2012, 'Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics', American Journal of Managed Care, vol. 18, no. 4, pp. 207-212.
Saifu HN, Asch SM, Goetz MB, Smith JP, Graber CJ, Schaberg D et al. Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics. American Journal of Managed Care. 2012 Apr;18(4):207-212.
Saifu, Hemen N. ; Asch, Steven M. ; Goetz, Matthew Bidwell ; Smith, Jason P. ; Graber, Christopher J. ; Schaberg, Dennis ; Sun, Benjamin. / Evaluation of human immunodeficiency virus and hepatitis C telemedicine clinics. In: American Journal of Managed Care. 2012 ; Vol. 18, No. 4. pp. 207-212.
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