Abstract

The COVID-19 pandemic precipitated a rapid shift to virtual service delivery in the United States, with telehealth adoption soaring across clinical specialties, patient conditions, and visit types. Nevertheless, evidence supporting telehealth’s effectiveness in primary care remains limited, especially for acute and preventive services. This study tested telehealth adoption and clinical outcomes across 54 primary care clinics affiliated with a single health system in the diverse, urban, and often low-income environment of Los Angeles County. Hierarchical multivariable models assessed clinical outcomes for 27 chronic disease cohorts, along with rates of acute care visits, preventive services, and safety events. The results indicated associations between elevated telehealth use and reduced utilization of in-person services for acute conditions such as respiratory infections, without negative effects on quality or patient-reported outcomes. Findings suggest that telehealth can facilitate quality primary care for well-defined conditions despite relatively low-volume adoption, and may serve as an effective adjunct to in-person care for preventive, chronic, acute, and mental health needs. Though telehealth is not a panacea, the evidence, when viewed in aggregate, supports its nuanced deployment as a patient-centered alternative within the wider multichannel service portfolio.

Keywords

  • Telehealth primary care COVID-19 outcomes telemedicine video visits telephonic visits chronic diseas

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