How does Telemedicine Affect the Last-Mile Delivery of Emergency Care? Evidence from Stroke Patients

Abstract

In healthcare, deficiencies in the hospital’s treatment capabilities always result in a mismatch between demand and services in the last-mile delivery of emergency care. Telemedicine , an approach to enabling offsite physicians to provide services virtually and quickly, shows great potentials for improving last-mile health care delivery. Using a large-scale stroke patient dataset in Florida from 2010 to 2016, this study empirically examines the impact of telemedicine on hospital treatment capability as well as health outcomes in last-mile care delivery. Based on the difference-in-differences (DID) framework, our findings show that telemedicine improves treatment capability in terms of operational efficiency, but no significant effect is found in the capability of care specialties. Regarding health outcomes, telemedicine decreases the in-hospital mortality rate and the hemiplegia rate. In addition, our study shows that stroke patients treated in hospitals with telemedicine have lower probability of discharge to nursing homes, which implies that the positive externality of telemedicine. Furthermore, our heterogeneous effect analysis indicates that telemedicine helps to address the disparity in resource allocation between urban and rural areas, by increasing capability of care specialties and reducing transfers for non-urban patients.

Note:
Funding Information: This project was supported in part by the National Natural Science Foundation of China [Grant 72201068].

Conflict of Interests: The authors declared no competing interest.

Keywords: telemedicine, stroke patients, treatment capability, operational efficiency, health outcome, discharge disposition, resource allocation disparity