BACKGROUND: Patients with tracheal diseases often require long-term follow-up after tracheal device placement, with a risk of adverse events that may lead to emergency care and unplanned interventions. Telemedicine has been proposed as an alternative to in-person follow-up to improve access and continuity of care. OBJECTIVE: The primary objective was to compare the need for emergency department visits between telemedicine and in-person groups. Secondary objectives included comparing hospital readmissions, 30-day hospital readmissions, and unplanned interventions between groups. METHODS: This retrospective, single-institution study included adult patients with tracheal devices who underwent telemedicine and in-person outpatient clinic visits between 2020 and 2024. To balance the groups, we used 1:1 propensity score matching. We collected demographic and clinical data and evaluated the need for emergency department visits, hospital readmissions, 30-day hospital readmissions, and unplanned interventions. Kaplan-Meier estimation of time to first emergency department visit was performed to assess outcomes after outpatient visits. RESULTS: A total of 483 patients (277 telemedicine and 206 in-person) underwent 2487 visits (1258 telemedicine and 1229 in-person). After propensity score matching, 336 patients remained (168 in each group). There were no significant differences in the need for emergency department visits, hospital readmissions, or unplanned interventions. Telemedicine group had significantly fewer 30-day hospital readmissions (OR = 0.38; 95% CI = 0.16-0.87; p = 0.021). Kaplan-Meier analysis indicated no statistically significant difference in emergency department-free visits. CONCLUSIONS: Telemedicine follow-up was associated with outcomes comparable to those of in-person follow-up in this cohort of adult patients with tracheal devices, with no evidence of an increased need for emergency department visits. In the matched analysis, telemedicine was associated with lower odds of 30-day hospital readmission.
Ciaralo et al. (Thu,) studied this question.