Outpatient Otolaryngology in the Era of COVID-19: A Data-Driven Analysis of Practice Patterns

• Published in: Otolaryngology-head and neck surgery Vol. 163; no. 1; pp. 138 - 144
• Main Authors: Kasle, David A., Torabi, Sina J., Savoca, Emily L., Judson, Benjamin L., Manes, R. Peter
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.07.2020
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Betacoronavirus; Child; Child, Preschool; Coronavirus Infections - complications; Coronavirus Infections - epidemiology; Coronavirus Infections - transmission; COVID-19; Data Analysis; Disease Transmission, Infectious - prevention & control; Female; finances; health care; Humans; Male; Middle Aged; Otolaryngologists - standards; otolaryngology; Otorhinolaryngologic Diseases - complications; Otorhinolaryngologic Diseases - therapy; Outpatients; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - epidemiology; Pneumonia, Viral - transmission; Practice Patterns, Physicians; Retrospective Studies; SARS-CoV-2; telehealth; Telemedicine - standards; United States - epidemiology; Young Adult; United States; COVID-19; otolaryngology; finances; telehealth; health care
• DOI: 10.1177/0194599820928987
• ISSN: 0194-5998

Introduction Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care. Study Design Retrospective review. Setting Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine. Subjects and Methods Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized. Results Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19–affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists (P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003). Conclusions A major decrease in the completion rates of scheduled visits was seen in the COVID-19–affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19–related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.