Musculoskeletal Telemedicine Trends Preceding the COVID-19 Pandemic and Potential Implications of Rapid Telemedicine Expansion

Table 1

Telemedicine use by study variables; absolute (unadjusted) numbers on the left and adjusted odds ratios with 95% confidence intervals on the right.

	Telemedicine utilization
	No	Yes	%	OR	95% CI
Telemedicine visit characteristics
Diagnosis
Low back/neck pain	62,521,546	14,573	0.02	Ref	—
Hip/knee pain	12,521,659	3618	0.03	0.75	0.72-0.77
Musculoskeletal aftercare	3,320,970	517	0.02	1.47	1.34-1.61
Other	111,897,399	18,964	0.02	0.85	0.83-0.87
Encounter type
Office visit; nonspecialized physician	19,864,435	29,867	0.15	Ref	—
Office visit; specialized physician	31,157,145	3574	0.01	0.15	0.14-0.15
Visit with nonphysician “professional”	91,163,682	3692	0	0.03	0.03-0.03
Other	48,076,312	539	0	0.01	0.01-0.01
Provider type
Primary care	21,402,964	24,407	0.11	Ref	—
Urgent care	7,338,940	3389	0.05	0.57	0.55-0.59
Orthopedic surgeon	19,486,716	1272	0.01	0.36	0.34-0.39
Other	142,032,954	8604	0.01	0.51	0.49-0.53
Copayment
Yes	65,571,904	8391	0.01	0.27	0.26-0.28
Year of visit
2014	55,513,807	2099	0	Ref	—
2015	33,998,374	2504	0.01	2.1	1.98-2.22
2016	35,029,043	3698	0.01	3.21	3.04-3.39
2017	32,745,728	11,524	0.04	12.1	11.6-12.7
2018	32,974,622	17,847	0.05	18.3	17.5-19.2
Patient characteristics
Sex
Male	75,401,273	17,573	0.02	Ref	—
Female	114,860,301	20,099	0.02	0.86	0.85-0.88
Age
<55 years	124,306,442	28,406	0.02	Ref	—
≥55 years	65,955,132	9266	0.01	0.69	0.67-0.71
Charlson comorbidity burden
0	103,308,569	23,356	0.02	Ref	—
1	43,267,583	8392	0.02	0.86	0.84-0.88
≥2	43,685,422	5924	0.01	0.68	0.66-0.70
Active opioid prescription	16,915,529	4756	0.03	0.9	0.88-0.93
Residence rurality
Urban	158,354,337	34,565	0.1	2.92	2.79-3.05
Rural	22,780,429	2341	0.1	Ref	—
Residence geographic region
Northeast	39,662,302	2825	0.01	Ref	—
North central	40,733,490	4149	0.01	1.35	1.28-1.42
South	73,553,316	12,705	0.02	2.28	2.19-2.38
West	34,737,212	17,907	0.05	5.58	5.36-5.81
Unknown	1,575,254	86	0.01	5.24	4.19-6.54
Median household income
<$45,000	12,106,955	1477	0.01	0.74	0.70-0.78
$45,000–$60,000	75,903,787	11,760	0.02	Ref	—
>$60,000	18,873,830	7608	0.04	2.57	2.49-2.65
Unknown	83,377,002	16,827	0.02	1.76	1.72-1.81

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