Association of primary care telehealth with preventable healthcare utilization and care continuity among patients with chronic conditions
7 affiliations
- 1Division of Health Policy and Economics, Department of Population Health Sciences, Joan & Sanford I. Weill Medical College, New York, NY USA
- 2Department of Population Health, NYU Grossman School of Medicine, New York, NY USA
- 3Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN USA
- 4Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY USA
- 5The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC USA
- 6Population Health Sciences, Joan & Sanford I. Weill Medical College, New York, USA
- 7Department of Biomedical Informatics, Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN USA
Abstract
Telehealth may help maintain access to care for individuals with chronic conditions, particularly during periods of disruption. This study examined the association between telehealth use and health care utilization, continuity, and quality in primary care. We used a difference-in-differences design (2019–2021) to compare outcomes for patients attributed to practices with high versus low telehealth uptake before and after the onset of the COVID-19 pandemic across three clinical research networks. Outcomes included evaluation and management visits, preventable emergency department visits, avoidable hospitalizations, Bice-Boxerman and Usual Provider of Care continuity indices, and disease-specific quality measures. Among 383,570 Medicare fee-for-service patient-quarters with chronic conditions, telehealth use was not associated with changes in preventable emergency department visits or hospitalizations. Continuity of care, measured by the Bice-Boxerman Index, increased by 0.01 (95% CI, 0.002 to 0.017), corresponding to an 8.3% greater increase relative to the pre-period mean in high versus low telehealth practices. However, telehealth use was associated with declines in selected disease-specific quality measures, including beta-blocker use among patients with heart failure (−0.04; 95% CI, −0.08 to −0.002) and controlled blood pressure among patients with hypertension (−0.10; 95% CI, −0.14 to −0.06). These findings suggest that telehealth may support continuity of care without increasing acute care utilization, although its implications for chronic disease management quality remain uncertain.
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BibTeX
@article{yu2026association,
title = {{Association of primary care telehealth with preventable healthcare utilization and care continuity among patients with chronic conditions}},
author = {Jiani Yu and Yiyuan Wu and Katerina Andreadis and William L. Schpero and Christopher A. Harle and Carol Horowitz and Saif Khairat and Rainu Kaushal and Mark Weiner and Jessica S. Ancker},
journal = {NPJ Digital Medicine},
year = {2026},
month = jul,
doi = {10.1038/s41746-026-02845-6},
url = {https://doi.org/10.1038/s41746-026-02845-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Association of primary care telehealth with preventable healthcare utilization and care continuity among patients with chronic conditions
AU - Jiani Yu
AU - Yiyuan Wu
AU - Katerina Andreadis
AU - William L. Schpero
AU - Christopher A. Harle
AU - Carol Horowitz
AU - Saif Khairat
AU - Rainu Kaushal
AU - Mark Weiner
AU - Jessica S. Ancker
PY - 2026
DA - 2026/07/06
JO - NPJ Digital Medicine
DO - 10.1038/s41746-026-02845-6
UR - https://doi.org/10.1038/s41746-026-02845-6
AB - Telehealth may help maintain access to care for individuals with chronic conditions, particularly during periods of disruption. This study examined the association between telehealth use and health care utilization, continuity, and quality in primary care. We used a difference-in-differences design (2019–2021) to compare outcomes for patients attributed to practices with high versus low telehealth uptake before and after the onset of the COVID-19 pandemic across three clinical research networks. Outcomes included evaluation and management visits, preventable emergency department visits, avoidable hospitalizations, Bice-Boxerman and Usual Provider of Care continuity indices, and disease-specific quality measures. Among 383,570 Medicare fee-for-service patient-quarters with chronic conditions, telehealth use was not associated with changes in preventable emergency department visits or hospitalizations. Continuity of care, measured by the Bice-Boxerman Index, increased by 0.01 (95% CI, 0.002 to 0.017), corresponding to an 8.3% greater increase relative to the pre-period mean in high versus low telehealth practices. However, telehealth use was associated with declines in selected disease-specific quality measures, including beta-blocker use among patients with heart failure (−0.04; 95% CI, −0.08 to −0.002) and controlled blood pressure among patients with hypertension (−0.10; 95% CI, −0.14 to −0.06). These findings suggest that telehealth may support continuity of care without increasing acute care utilization, although its implications for chronic disease management quality remain uncertain.
SN - 2398-6352
ER -