Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 17, 2025
Date Accepted: Apr 14, 2026
Is Telemedicine as effective as face-to-face consultation in fighting COVID-19: A retrospective cohort study of adult COVID-19 patients in a primary care setting
ABSTRACT
Background:
Coronavirus disease 2019 (COVID-19) was a global pandemic that had a devastating impact on healthcare worldwide. The effectiveness of the Telemedicine compared to traditional face-to-face consultations for managing COVID-19 patients with mild symptoms remained unknown.
Objective:
To evaluate the effectiveness of Tele-Designated Clinics (Tele-DC) in reducing hospitalization and severe complications among COVID-19 patients with mild symptoms managed in public primary care setting in Hong Kong.
Methods:
A cohort study was conducted to compare the effectiveness of Tele-DC with face-to-face physical DC (PDC) in managing COVID-19 patients. This study included all COVID-19 patients who attended Physical Designated Clinics (PDC) or Tele-DC at one cluster of public primary care clinics in Hong Kong from 28 July 2022 to 29 January 2023. The primary outcome was the hospital admission rate between day 1 and day 28 after first attendance at Tele-DC or PDC. Other outcomes include severe complication rate, mortality rate, emergency service utilization rate and DC reattendance rate. Patients characteristics, health service utilization, prescription of antiviral drugs, development of severe complications and mortality of COVID-19 patients attending the Tele-DC and PDC were compared.
Results:
After propensity score matching, there were 17,199 patients in each group. Compared with PDC group, COVID-19 cases from Tele-DC group demonstrated similar hospital admission rate (Tele-DC vs PDC, 2.89% vs 2.74%, P=0.397), length of stay (LOS) (6.92±0.47 vs 6.61±0.50 days, P=0.656), severe complication rate (0.27% vs 0.19%, P =0.176), and mortality rate (0.13% vs 0.10%, P=0.390). However, patients from Tele-DC group exhibited a higher Accident and Emergency Department (AED) attendance rate (3.73% vs 3.15%, P=0.003) and DC re-attendance rate (8.41% vs 7.48%, P=0.002).
Conclusions:
Tele-DC was as effective as face-to-face consultations in preventing hospitalization and severe cases among COVID-19 patients with mild symptoms in primary care setting.
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