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TABLE 7.3Evaluating Access to Care

Did telemedicine affect the use of services or the level or appropriateness of care compared to the alternative(s)?
What was the utilization of telemedicine services before, during, and after the study period for target population and clinical problem(s)?
When offered the option of a telemedicine service, how often did patients
  • accept or refuse an initial service or fail to keep an appointment
  • accept or refuse a subsequent service or fail to keep an appointment?
What was the utilization of specified alternative services before, during, and after the study period for the target population and clinical problem(s)?
  • consultants traveling to distant sites
  • patients traveling to distant consultants
  • consultation by mail or courier
  • transfers to other facilities
  • self-care
Was the telemedicine application associated with a difference in overall utilization (e.g., number of services or rate) or indicators of appropriateness of care for
  • specialty care
  • primary care
  • transport services
  • services associated with lack of timely care?
Did the application affect the timeliness of care or the burden of obtaining care compared to the alternative(s)?
Was there a difference in the
  • timing of care
  • appointment waiting times for referrals?
What were patient attitudes about the
  • timeliness of care
  • burden of obtaining care
  • appropriateness of care?
What were the attitudes of attending and consulting physicians and other personnel about the
  • timeliness of care
  • burden of providing care
  • appropriateness of care?

NOTE: Each question assumes that an analysis of results will control for or take into account severity of illness, comorbidities, demographic characteristics, and other relevant factors.

From: 7, Evaluating the Effects of Telemedicine on Quality, Access, and Cost

Cover of Telemedicine
Telemedicine: A Guide to Assessing Telecommunications in Health Care.
Institute of Medicine (US) Committee on Evaluating Clinical Applications of Telemedicine; Field MJ, editor.
Washington (DC): National Academies Press (US); 1996.
Copyright © 1996, National Academy of Sciences.

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