The Impact of Telehealth and Care Coordination on the Number and Type of Clinical Visits for Children With Medical Complexity

IntroductionThe purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration.MethodThis was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups. The focus of the analysis was planned and unplanned clinical and therapy visits by CMC over a 30-month data collection period. Nonparametric tests were used to compare visit counts among and within the three groups.ResultsThe number of unplanned visits decreased over time across all groups, with the greatest decrease in the video telehealth intervention group. Planned visits were higher in the video telehealth group across all time periods.DiscussionAdvanced practice registered nurse-delivered telehealth care coordination may support a shift from unplanned to planned health care service use among CMC.