Variation in Telehealth Use for Patients with Incident Atrial Fibrillation Across the Veterans Health Administration: Retrospective Cohort Study (Preprint)

• DOI: 10.2196/preprints.76177
• Publication Date: 2025-04-21T04:10:07Z
• Authors: Rebecca Lauren Ti...; Neil Manohar Kalwani; Harrison Koos; Jun Fan; Natasha Din; Alexander Carroll...; David C. Chan; Alexander Tarloch...; Paul A. Heidenreich
• Keywords: Telehealth; Preprint

<sec> <title>BACKGROUND</title> Telehealth is a potential tool to alleviate geographic cardiology specialist shortages, but there limited data regarding current telehealth use for common conditions, including atrial fibrillation (AF). </sec> <title>OBJECTIVE</title> We evaluated variation in primary care and clinics patients with incident AF the Veterans Health Administration (VA). <title>METHODS</title> constructed cohort of diagnoses made outpatient setting 1/2022-9/2023. included facility-specialty groups at least 20 visits these between 1/2022-12/2023. assessed association any video visit (including phone) or within 90 days diagnosis selected patient facility characteristics using Bayesian logistic regression, random intercepts. via median odds ratio (MOR). <title>RESULTS</title> Our 36,929 new AF, 80,596 across 125 facilities. Of these, 2,088 63,835 (3.3%) 323 16,761 (1.9%) were delivered by 13,403 (21.0%) 3,288 (19.6%) telehealth. Average age was 74, 2.9% female, 78% White, average CHA2DS2-VASc 2.8. In adjusted analyses, older associated lower both (e.g., [AOR] 0.61 [95% credible interval, CrI, 0.42-0.85] than 77). Living &gt;40 miles from increased AOR 1.91 CrI 1.21-3.00] care); rural location (video 0.73 0.64-0.84]; 0.89 0.83-0.96]). There marked variability facilities (range 0%-17.4% cardiology, 0%-12.5% care) 0%-82.6% 3.8%-61.6% this population. The facility-level MOR 1.97 (95% CrI: 1.77-2.24) 4.95 3.39-7.98) cardiology. Similarly, 1.79 1.65-1.96) 2.61 2.25-3.13). <title>CONCLUSIONS</title> Following diagnosis, may increase access living distance, its remains those geographies. significant not explained differences characteristics. Standardizing VA improve care.