Article Figures & Tables
Figures
- Figure 1:
Age–sex standardized rates and standard error of emergency department visits for transient ischemic attack or ischemic stroke per 100 000 discharged without admission.
- Figure 2:
Pattern of clinic visits within 90 days of emergency department discharge for transient ischemic attack or minor stroke.
- Figure 3:
Forest plot of the risk difference (RD) and 95% confidence interval (CI) of clinic visits, stroke investigations and medication refills after the implementation of telemedicine compared with before. Note: ED = emergency department.
Tables
- Table 1:
Patient characteristics before and after the implementation of outpatient telemedicine billing codes
Characteristic No. (%) of patients* Std. diff.† Apr. 1, 2015, to Mar. 31, 2020
n = 40 098Apr. 1, 2020, to Mar. 31, 2021
n = 7503Age, yr, median (IQR) 73 (62–82) 73 (62–81) 0.024 Sex, female 19 786 (49.3) 3682 (49.1) 0.005 Neighbourhood income quintile 1 (lowest) 8583 (21.4) 1465 (19.5) 0.047 2 8479 (21.1) 1540 (20.5) 0.015 3 8035 (20.0) 1506 (20.1) 0.001 4 7334 (18.3) 1436 (19.1) 0.022 5 (highest) 7536 (18.8) 1532 (20.4) 0.041 Missing 131 (0.3) 24 (0.3) 0.001 Residence Large urban (population > 100 000) 29 832 (74.4) 5485 (73.1) 0.029 Medium urban (population 10 000–100 000) 4512 (11.3) 848 (11.3) 0.002 Small town (population < 10 000) 5754 (14.3) 1170 (15.6) 0.035 Most responsible diagnosis Ischemic stroke 10 035 (25.0) 1871 (24.9) 0.002 Transient ischemic attack 30 063 (75.0) 5632 (75.1) 0.002 ED hospital type Comprehensive stroke centre 8041 (20.1) 1758 (23.4) 0.082 Primary stroke centre 7002 (17.5) 1458 (19.4) 0.051 Nondesignated stroke centre 25 055 (62.5) 4287 (57.1) 0.109 Hypertension 28 239 (70.4) 4995 (66.6) 0.083 Diabetes 12 458 (31.1) 2367 (31.5) 0.010 Atrial fibrillation 7015 (17.5) 1203 (16.0) 0.039 Dyslipidemia 16 028 (40.0) 2880 (38.4) 0.033 History of stroke 4202 (10.5) 715 (9.5) 0.032 Coronary artery disease 5915 (14.8) 984 (13.1) 0.047 Peripheral artery disease 1374 (3.4) 194 (2.6) 0.049 Baseline medication use Antihypertensive 20 652 (51.5) 3827 (51.0) 0.010 Antihyperlipidemic 17 320 (43.2) 3388 (45.2) 0.039 Antihyperglycemic 5737 (14.3) 1146 (15.3) 0.027 - Table 2:
Admission and death within 90 days of emergency department discharge before and after the implementation of outpatient telemedicine billing codes
Variable No. (%) of patients Rate (95% CI) per 100 person-month Adjusted HR* (95% CI) Apr. 1, 2015, to Mar. 31, 2020
n = 40 098Apr. 1, 2020, to Mar. 31, 2021
n = 7503Apr. 1, 2015, to Mar. 31, 2020
n = 40 098Apr. 1, 2020, to Mar. 31, 2021
n = 7503All-cause admission 6216 (15.5) 1107 (14.8) 5.9 (5.7 to 6.0) 5.6 (5.3 to 5.9) 0.97 (0.91 to 1.04) Stroke admission 1567 (3.9) 311 (4.1) 1.4 (1.3 to 1.4) 1.5 (1.3 to 1.6) 1.06 (0.94 to 1.20) Death 1141 (2.8) 220 (2.9) 1.0 (0.9 to 1.0) 1.0 (0.9 to 1.1) 1.07 (0.93 to 1.24) Note: CI = confidence interval, HR = hazard ratio.
↵* Adjusted for age (continuous), sex, neighbourhood income, rurality, most responsible diagnosis (transient ischemic attack v. stroke), hypertension, diabetes, atrial fibrillation, dyslipidemia, history of stroke, coronary artery disease and peripheral artery disease.
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