JMIR Publications

ABSTRACT

Background:

Since its introduction, telemedicine for patients with chronic diseases has been studied in various clinical settings. However, there is limited evidence of the effectiveness and medical safety of the nationwide adoption of telemedicine.

Objective:

This study aimed to analyze the effects of telemedicine on chronic diseases during the COVID-19 pandemic under a temporary telemedicine policy in South Korea using national claims data.

Methods:

Health insurance claims data were extracted over two years: one year before (from February 24, 2019, to February 23, 2020) and one year after the policy was implemented (from February 24, 2020, to February 23, 2021). We included all patients who used telemedicine at least once the first year after the policy was implemented and compared them with a control group of patients who never used telemedicine. The comparison focused on healthcare utilization, the medication possession ratio (MPR), and admission rates to general wards (GWs), emergency departments (EDs), and intensive care units (ICUs) using difference-in-differences (DID) analysis. Four chronic diseases were targeted: hypertension (HTN), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and common mental disorders.

Results:

A total of 1,773,454 patients with HTN, 795,869 patients with DM, 37,460 patients with COPD, and 167,084 patients with common mental disorders were analyzed in this study. Patients diagnosed with HTN or DM showed increased MPRs without an increase in GW, ED, or ICU admission rates during the policy year. Moreover, patients in the DM group who did not use telemedicine had higher rates of ED, GW, and ICU admissions, and patients in the HTN group had higher rates of GW or ICU admissions after one year of policy implementation. This trend was not evident in the COPD and common mental disorders.

Conclusions:

The temporary telemedicine policy was effective in increasing medication adherence and reducing admission rates for HTN and DM patients; however, the efficacy of the policy was limited for COPD and common mental disorder patients. Future studies are required to demonstrate the long-term effects of telemedicine policies with various outcome measures reflecting disease characteristics. Clinical Trial: N/A