Zi study on outpatient telemedical care 2017-2021 published
13.07.2023 15:18
Telemedicine in high demand during the corona pandemic. Psychotherapy is by far the strongest care offering. Young women in urban areas use digital treatment most often
In the Corona years 2020 and 2021, the proportion of contract doctors and contract psychotherapists who billed telemedical services increased massively. While it was only 4.5 percent in 2017, this proportion shot up to 25 percent in 2021. The proportion of the fee requested for this in the corresponding total fee (2021: 0.8 percent, 2017: 0.0 percent) as well as the proportion of patients receiving telemedical services among all those with statutory health insurance (2021: 1.9 percent, 2017: 0, 2 percent) has also increased significantly compared to the previous years 2017 to 2019. The telemedicine services provided since 2020 in the context of the COVID-19 pandemic can predominantly be assigned to the psychotherapeutic care area. The average fee requirement per patient for all billed services (telemedicine and other services) for patients with telemedicine services was above average (2021: 1,777 euros) compared to the rest of the population of legally insured people (2021: 594 euros).
Half of the fee requirement for new telemedicine patients in 2020 was for psychotherapy
The significant increase in the number of patients billed for telemedicine services in the first pandemic year of 2020 is largely due to patients for whom telemedicine was prescribed for the first time from 2020 onwards. Almost half of the fee requirement for new telemedicine patients in 2020 was for psychotherapy. 39 percent of patients receiving telemedical care lived in large cities, were younger on average (42 years old) and a higher proportion were women (63 percent). These are the central results of a current care atlas study by the Central Institute for Statutory Health Insurance (Zi) on “Telemedicine as an alternative access to statutory outpatient care – trends in the period 2017 to 2021”.
The number of video consultations increased significantly during the Corona period
“Personal contact is still the rule in outpatient care. During the Covid-19 pandemic, the options for telemedicine services have been expanded to reduce the risk of infection and enable medical care despite mobility restrictions. Resident doctors and psychotherapists have taken advantage of these opportunities. In previous data evaluations, we were able to show that the number of video consultations increased significantly during the Corona period and that utilization was very much influenced by the course of the pandemic. The current analysis now clearly shows that it was psychotherapists in particular who offered video consultations during this time. For the first time, we have also highlighted regional differences in the care of new telemedicine patients since 2020. The corresponding shares fluctuate between 0.82 and 2.91 percent. The highest proportions can be found in Berlin, Hamburg and Bavaria, the lowest in Mecklenburg-Western Pomerania, Saxony-Anhalt and Saxony," said Zi CEO Dr. Dominik von Stillfried.
Potential in the expanded tasks of the appointment service centers for arranging video consultations
After proving itself in times of crisis, it is now necessary to observe what role telemedicine will play in the future and what significance it can have in the field of psychotherapy, but also in other specialist groups. “According to preliminary data analyses, the number of billed video consultations fell slightly again in the first half of 2022. However, the telemedical services in the area of outpatient emergency care, which were significantly expanded in the third quarter of 2022 to cope with the wave of infections, could bring a further boost to digitization. This could increase the use of video consultations in the future. We also see potential in the expanded tasks of the appointment service points to arrange video consultations,” continued von Stillfried. However, previous international experience suggests that only a fraction of telemedicine should be video-based as long as other alternatives prove to be more efficient.
The data basis for the present study was the nationwide contract medical billing data in accordance with Section 295 SGB V from 2017 to 2021. The study populations were the billing contract doctors/psychotherapists and those insured by statutory health insurance (GKV) with at least one annual contact with a doctor in Germany. According to the definition of the Telemedicine Working Group of the German Medical Association, telemedicine is defined as medical services that are provided over spatial distances or time offsets and in which information and communication technologies are used. On this basis, 795 relevant fee schedule items (GOP) from the Uniform Assessment Standard (EBM) were selected. Procedures that have been in place for years, such as telephone advice, were not included in the evaluation.