Currently submitted to: Journal of Medical Internet Research
Date Submitted: Mar 16, 2026
Open Peer Review Period: Mar 17, 2026 - May 12, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Safety of telemedicine versus in-person care for patients with tracheal devices: A propensity score–matched cohort study
ABSTRACT
Background:
Patients with tracheal diseases often require long-term follow-up after tracheal device placement, with a risk of adverse events that may lead to emergency care and unplanned interventions. Telemedicine has been proposed as an alternative to in-person follow-up to improve access and continuity of care.
Objective:
The primary objective was to compare the need for emergency department visits between telemedicine and in-person groups. Secondary objectives included comparing hospital readmissions, 30-day hospital readmissions, and unplanned interventions between groups.
Methods:
This retrospective, single-institution study included adult patients with tracheal devices who underwent telemedicine and in-person outpatient clinic visits between 2020 and 2024. To balance the groups, we used 1:1 propensity score matching. We collected demographic and clinical data and evaluated the need for emergency department visits, hospital readmissions, 30-day hospital readmissions, and unplanned interventions. Kaplan–Meier estimation of time to first emergency department visit was performed to assess outcomes after outpatient visits.
Results:
A total of 483 patients (277 telemedicine and 206 in-person) underwent 2487 visits (1258 telemedicine and 1229 in-person). After propensity score matching, 336 patients remained (168 in each group). There were no significant differences in the need for emergency department visits, hospital readmissions, or unplanned interventions. Telemedicine group had significantly fewer 30-day hospital readmissions (OR = 0.38; 95% CI = 0.16–0.87; p = 0.021). Kaplan–Meier analysis indicated no statistically significant difference in emergency department–free visits.
Conclusions:
A telemedicine outpatient program is safe for the follow-up of adult patients with tracheal devices.
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