PRP143: Preventive Care Utilization by Patients who Use Virtual Urgent Care

Carole Berini, MSc; Marty Player, MD, MSCR; Dee Ford, MD, MSc; Ryan Kruis, MSW; Justin Marsden; Patrick Mauldin; Vanessa Diaz, MD, MS

Abstract

Context: Virtual Urgent Care (VUC), which provides care for acute common conditions through chat, e-visits or video visits, is a convenient way for patients to access health care. It is unclear if using VUC impacts receiving preventive services, as it can supplant in-person visits where individuals might have received preventive services counseling. Objective: Describe the population that has utilized VUC, and describe their use of preventive services. Study Design: Cross-sectional study. Setting: General population. Population Studied: Patients who receive care for acute, common conditions through VUC with available preventive services data. Outcome Measures: Completion of recommended preventive services per the United States Preventive Services Task Force guidelines based on the individual’s age and gender. Preliminary Results: From the start of the VUC program in July 2018 to December 2019, a total of 13,216 virtual urgent care visits have been completed by 7698 unique patients. Of those patients, 5428 were identified as having preventive services data available for review. These patients were mostly female (76%), White (80%), under 40 years old (62%) and had an average of 3.0 office visits per year. Preliminary results show the following proportion of eligible patients being overdue for these recommended services: 35 % for mammogram, 47% for PAP Smear, 57% for Influenza vaccine, and 58% for Tdap vaccine. In stratified analyses, individuals without an in-person visit to their primary care practice in the last year were more likely to be overdue for Tdap vaccinations (80% vs 51%, p<0.001), influenza vaccination (91% vs 45%, p<0.001) mammograms (71% vs 29%, p<0.001) and pap smears (76% vs 39%, p<0.001) than individuals with at least one primary care visit. Conclusions: Continued work on this study will evaluate other preventive measures (eg blood pressure screening, HIV screening, lipid testing) and further stratify the population to identify factors associated with receiving recommended preventive services. Better understanding of the patients using Virtual Urgent Care and their utilization of preventive care services will help to identify gaps in care. This information could then guide subsequent development of strategies to improve VUC user’s overall health and wellness by encouraging completion of recommended preventive services.

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