Outpatient Otolaryngology in the Era of COVID-19: A Data-Driven Analysis of Practice Patterns

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care.

Study design: Retrospective review.

Setting: Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine.

Subjects and methods: Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized.

Results: Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19-affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists (P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003).

Conclusions: A major decrease in the completion rates of scheduled visits was seen in the COVID-19-affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19-related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.

Keywords: COVID-19; finances; health care; otolaryngology; telehealth.

Figure 1.

(A) Total breakdown of scheduled visits to the Yale otolaryngology division in 2019 and 2020. (B) Weekly breakdown of number of completed in-person and telehealth visits in 2020.

Figure 2.

(A) Breakdown of scheduled 2020 telehealth visits. (B) Weekly breakdown of scheduled 2020 telehealth visits. (C) Completion rates of in-person 2019 visits vs telehealth 2020 visits.

Figure 3.

(A) Visits breakdown by specialty. (B) Weekly breakdown of telehealth vs inpatient visits by specialty. (C) Proportion of completed visits to otolaryngology physicians between 2019 and 2020.

Figure 4.

(A) Visits breakdown by age. (B) Weekly breakdown of telehealth vs inpatient visits by age. (C) Proportion of 2020 in-person and telehealth visits between younger (18-64 years) and older (≥65 years) adults.