Research Article Musculoskeletal Telemedicine Trends Preceding the COVID-19 Pandemic and Potential Implications of Rapid Telemedicine Expansion

摘要: 2.1. Study Design, Database, and Sample. This retrospective study used patient-level private insurance claims from> 100 payers from the Truven MarketScan database to identify telemedicine visits that occurred between 2014 and 2018 (n= 846,461,609 visits; copyright© 2017 Truven Health Analytics Inc.; dataset access was limited to Hospital for Special Surgery employees). To extract musculoskeletal-specific outpatient visits (n= 190,299,246 visits), the cohort was filtered using ICD-10 codes that are associated with the musculoskeletal major diagnostic category(MDC). Telemedicine visits were defined using current procedural terminology codes 99441-99444; Healthcare Common Procedure Coding System codes G0406-G0408, G0459, G0508-G0509, G0425-G0427, Q3014, and T1014; or any code with either a procedure modifier of GT, GQ, or 95 or a location of service listed as “telehealth”[16].2.2. Study Variables. The primary outcome of this analysis was the utilization of telemedicine as the modality of a patient visit. The study variables considered included both patientspecific variables and telemedicine visit characteristics. Patient-specific variables included the following: sex, age, Charlson-Deyo Comorbidity Index (categories: 0, 1, 2,> 2, with a higher score representing a higher comorbidity burden)[17], active opioid use, residence rurality (urban, rural), residence geographic region (northeast, north central, south, west, unknown), and median household income. Telemedicine visit characteristics included the following: diagnosis, encounter type, provider type, copayment, and year of visit (2014-2018). Using ICD-10 codes, the diagnoses …