Evidence map›Paper›PMID 41331911›Full record

ArticleBMC geriatrics2025

The impact of telephone-based telemedicine on unplanned hospital visits and mortality risk during the COVID-19 pandemic: a study from a middle-income country.

Unchana Sura-Amonrattana, Kasemsan Kertkiatkachorn, Supawadee Sainimnuan, Rinrada Preechitkul, Ponnapa Petchthai, Pattara Leelahavarong, Jeeranan Jantaraprapan, Sutisa Pitiyarn, Arunotai Siriussawakul, Varalak Srinonprasert and 1 more

Abstract read
In one paragraph

Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Unchana Sura-Amonrattana *Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-4642-0401
Kasemsan Kertkiatkachorn *Department of Social Medicine, Prapokklao Hospital, Chanthaburi, Thailand.
Supawadee SainimnuanFaculty of Medicine Siriraj Hospital, Siriraj Health Policy Unit, Mahidol University, Bangkok, Thailand.
Rinrada PreechitkulFaculty of Medicine Siriraj Hospital, Siriraj Health Policy Unit, Mahidol University, Bangkok, Thailand.
Ponnapa PetchthaiFaculty of Medicine Siriraj Hospital, Siriraj Health Policy Unit, Mahidol University, Bangkok, Thailand.
Pattara LeelahavarongFaculty of Medicine Siriraj Hospital, Siriraj Health Policy Unit, Mahidol University, Bangkok, Thailand.
Jeeranan JantaraprapanDepartment of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sutisa PitiyarnDepartment of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Arunotai SiriussawakulDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Varalak SrinonprasertDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. varalaksi@gmail.com.
Chairat PermpikulDivision of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProviding care via telemedicine was suggested worldwide during the COVID-19 pandemic. A new care model and service flow using telephone-based telemedicine (2T SAVE-COVID project) was established to provide care for patients at the Department of Medicine during the pandemic. This study aimed to investigate the clinical outcomes of patients after receiving care through telemedicine in the project.

methodsA retrospective cohort study was conducted to compare the clinical outcomes of patients receiving telemedicine compared to routine care at the outpatient clinics of the Medicine department from April 2020 to November 2021, including an original cohort (routine care: n = 54,032; telemedicine: n = 16,388) and a propensity score-matched cohort (n = 16,246 per group). Baseline and clinical characteristics, rates of unplanned visits and mortality outcomes were analyzed. Time prior to unplanned visits was calculated, and multivariate analysis was performed to identify predictors of unplanned visits.

findingsIn the original cohort, the telemedicine group demonstrated a significantly higher incidence of unplanned outpatient visits (19.7% vs. 18.5%, p < 0.001). Conversely, in the matched cohort, the telemedicine group showed a lower rate of unplanned outpatient visits (19.4% vs. 59.3%, p < 0.001). Multivariate analysis confirmed that telemedicine was independently associated with a reduced risk of unplanned visits (adjusted HR: 0.69, 95% CI: 0.65 - 0.74, p < 0.001). However, other predictors with an increased incidence of unplanned visits included female patients, patients with chronic kidney disease stage 3 to 5, cancer and serum albumin levels below 4 g/dL. Additionally, telemedicine is associated with significantly lower mortality rates compared to routine care.

interpretationTelephone-based telemedicine can be a viable alternative to routine care, offering comparable or improved outcomes in terms of a reduced rate of unplanned visits and lower mortality rates, particularly when combined with appropriate patient selection and monitoring strategies.

Indexed as

COVID-19HospitalizationTelemedicineTelephoneAgedCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2COVID-19 pandemicOlder peopleTelemedicineTelephone-basedUnplanned visits

Identifiers

PMID41331911
PMCPMC12673738

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.