Congestive heart failure (CHF) is a condition that impairs the heart’s ability to pump sufficient blood throughout the body, potentially leading to complications such as difficulty breathing, kidney damage, and other cardiac conditions.1 CHF is the second most common non-maternal cause of hospitalizations in the United States.2 Among patients hospitalized for heart failure, the risk of death or rehospitalization is high.3
To assess whether telehealth care for CHF patients is correlated with a change in the likelihood of visiting an emergency department (ED) or being admitted to a hospital due to a CHF exacerbation, we studied 62,129 patients diagnosed with CHF between January 1, 2017, and December 31, 2022, who had five in-person outpatient and/or telehealth visits in the year following their CHF diagnosis. We selected the same visit count for all patients to minimize the potential for confounding due to potential differences in the amount of care received during the study period. We evaluated whether the patient had a CHF-related ED encounter or admission in the second year after CHF diagnosis. We adjusted for age, sex, race, ethnicity, Social Vulnerability Index quartile, diuretic or digoxin prescriptions, smoking status, presence of an ED visit or admission in the previous year, setting where CHF was initially diagnosed (ED, outpatient, or admission), and history of comorbidities.
We found that CHF patients with a higher proportion of telehealth visits were no more likely to have an ED visit or admission for CHF than patients who had only in-person visits, as seen in Figure 1.
A sensitivity analysis expanding the population to patients with any number of visits in the year after CHF diagnosis also showed no difference in the likelihood of CHF-related ED visits or admissions by the volume of telehealth visits the patient had. Our study did not consider specific indicators of CHF disease severity such as ejection fraction, which may influence whether a patient is more likely to receive care in person than through telehealth.
These findings suggest telehealth may be considered a substitute for in-person office visits for patients with CHF without affecting the likelihood of CHF-related ED visits or hospital admissions.
