Saxon, T Day
| Saxon, T Day |
Saxon T Day, Michael, J Cimba, Puhan He, Kevin Francois, Trinh Chau, Rania, A Habib, Helen Giannakopoulos, Rabie, M Shanti
Anh Le
Oral and Maxillofacial Surgery, University of Pennsylvania School of Dental Medicine
Introduction
The COVID-19 pandemic changed the landscape of healthcare. Resource limitation and quarantine policies also affected care of patients with non-COVID-19 related conditions such as those seen in the Department of Oral Maxillofacial Surgery. Telehealth became an integral part of many health care systems to continue provision of care. This study aims to evaluate the impact of the COVID-19 on the utilization of telehealth in Oral Maxillofacial Surgery.
Methods
This is a retrospective descriptive study of patients presenting to the Oral Maxillofacial Surgery Department outpatient clinic in University of Pennsylvania between March 1st, 2020 and March 1st, 2021. The primary predictor variable included number of cases in Philadelphia as a proxy for severity of the pandemic by month, and the primary outcome variable is the frequency of telehealth visits based on visit types (new patient versus return patient). Covariates include patient demographics including age, race and sex, as well as encounter diagnoses.
Results
The number of telehealth visits does not correlate with the severity of the pandemic, rather, it directly reflects policy implementation such as the lock down and prohibition of elective procedures and visits. In the state of Pennsylvania, in the time period of the study, the peak incidence rate occurred on December 16th, at a rate of 10,190 new infections. In-person visits experienced a precipitous drop in the month of April 2020 following restriction of non-emergent service, from 100% to 71.1% for new patients and 92.1% to 5.3% for return patients. The largest percentage of telehealth visits were the ages between 30 to 39, 40 to 49, and 50 to 59 years old at 16% for each group and were lowest at 11% in ages 70 to 79, and 9% in those ages 18 and 19 years old. The two groups with the highest percentage of telehealth visits were patients that identified as White and Other at 15%, followed by patients who identified as Asian at 14%, and Black at 11%. Sixteen percent of female patients utilized telehealth visits while 11% of male patients utilized telehealth visits. The diagnosis coded at the highest frequency during this time period was lichen planus at 81 encounters, followed by myofascial muscle pain (65), articular disc disorder of the temporomandibular joint (48), surgery follow-up (41), joint replacement (39), stomatitis and mucositis (35) drug-induced osteonecrosis of the jaw (35), tongue dysplasia (32), acquired oral dysplasia (32), and other dystonia (30).
Conclusion
Effective implementation of policies is the best method to mitigate effect of COVID-19 and directly influence utilization of telehealth. Telehealth encounters allowed continued provision of care during the pandemic.