Variation in Patterns of Telestroke Usage during the COVID-19 Pandemic

ABSTRACT

Objectives Early in the pandemic there was a substantial increase in telestroke uptake among hospitals. The motivations for using telestroke during the pandemic might be different than hospitals that adopted telestroke previously. We compared stroke care among hospitals that adopted telestroke prior to the pandemic to hospitals that adopted telestroke during the pandemic. Materials and Methods Stroke episodes and telestroke use were identified in Medicare Fee-for-Service Data. Hospital and episode characteristics were compared between pre-pandemic (Jan. 2019 – Mar. 2020) and pandemic (Apr. 2020 – Dec. 2020) adopters. Results Hospital bed counts, critical access status, stroke volumes, clinical operating margins, share of stroke care via telestroke, and vascular neurology consult rates did not differ significantly between pre-pandemic and pandemic-adopting hospitals. Hospitals that never adopted telestroke during the study period were more likely to be small critical access hospitals with low clinical operating margins. Conclusions Compared to hospitals that adopted telestroke before the pandemic, hospitals that adopted telestroke during the pandemic were similar in characteristics and how they used telestroke.