After-hours telemedicine Pediatric Medical Consultation Center – does it meet medical needs?

Shlomo Vinker, Michal Shuster, Aviva Elad, Avivit Golan Cohen

Keywords: telemedicine, pediatrics, healthcare services, overtreatment

Background:

Healthcare providers in Israel (HMOs) provide their members with online after-hours medical services as part of their regulatory obligation to ensure 24/7 out-of-hospital care.
Online pediatric medical call centers do not replace routine care. Although the utilization of this service is increasing, the quality and impact on patients' outcomes have not yet been thoroughly studied.

Research questions:

To characterize the children who use the telemedicine service compared to those who do not.

Method:

A cross-sectional comparative study was conducted, analyzing the demographic and clinical data of all pediatric patients in Leumit HMO. The study compared children who used the online pediatric service (users) at least once between 2021 and 2023 to non-users.

Results:

148,868 were non-users in comparison to 30,930 users. Children who used the service were younger (8.1 ± 4.2 years vs. 10.8 ± 4.2 years, P < 0.05), had higher socioeconomic status (27.1% in socioeconomic clusters 1–5 vs. 12.1%, P < 0.05), visited pediatricians in the community almost twice as often, and were twice as likely to visit emergency departments (EDs). They also had slightly higher rates of chronic conditions such as asthma, allergies, developmental issues, and gastrointestinal diseases. However, no significant differences were found in their average hospitalization days or the prevalence of other diseases.

Conclusions:

Children utilizing out-of-hours telemedicine services tend to be younger and consume more healthcare services. Evaluating the overtreatment and its consequences in this population is mandatory.

Points for discussion:

How to evaluate the service in other ways?

How to make a better triage to patients that are using the service?