A Retrospective Secondary Data Analysis of Telemedicine Service Utilization (2020-2023) Among Patients Covered By The Universal Coverage Scheme in Thailand.

Objective: The National Health Security Office in Thailand introduced a telemedicine program called "Telehealth/Telemedicine" in December 2020, which aimed to reimburse telemedicine services for patients with stable chronic diseases under the Universal Coverage Scheme (UCS). The current study investigated patient characteristics and trends in telemedicine service utilization under the UCS in Thailand and examined the impact of COVID-19 outbreaks on telemedicine services. Methods: A retrospective secondary data analysis using e-claim data from December 1, 2020, to April 18, 2023, was conducted. The analytical methods included descriptive analysis and an interrupted time series analysis. Results: During ∼29 months, 110,153 unique patients used telemedicine services, leading to a total of 259,047 visits. The average age was 54 years, and most of patients were female (57%). Hypertension was the most common diagnosis for patients receiving telemedicine services. Patients with mental health conditions often engaged in telemedicine consultation with drug delivery. During the Delta and Omicron outbreaks, telemedicine service utilization significantly increased compared with that in any nonpandemic periods within the 29-month timeframe (odds ratio [OR]: 3.85, p-value <0.01; OR: 2.55, p-value <0.01). Conclusions: The study findings highlight the initial trend of telemedicine services in Thailand from the start of the COVID-19 pandemic to the beginning of the post-COVID-19 period. As telemedicine will play a critical role in the future of health care, this information can support the scale-up of telemedicine, including monitoring and evaluation plans, to help improve the efficiency of the system.

Telemedicine Utilization Patterns and Implications Amidst COVID-19 Outbreaks in Thailand Under Public Universal Coverage Scheme.

During COVID-19 pandemic, telemedicine was a strategy to facilitate healthcare service delivery minimizing the risk of direct exposure among people. In Thailand, the National Health Security Office has included telemedicine services under the Universal Coverage Scheme to support social distancing policies to reduce the spread of COVID-19. This study aimed to determine the patterns of telemedicine service use during major COVID-19 outbreaks including Alpha, Delta, and Omicron in Thailand. We retrospectively analyzed a dataset of telemedicine e-claims from the National Health Security Office, which covers services reimbursed under the Universal Coverage Scheme between December 2020 and August 2022. An interrupted time-series analysis, Pearson correlation analysis and binary logistic regression were performed. Almost 70% of the patients using telemedicine services were over 40 years old. Most patients used services for mental health problems (25.6%) and major noncommunicable diseases, including essential hypertension (12.6%) and diabetes mellitus (9.2%). The daily number of using telemedicine service was strongly correlated with the number of COVID-19 new cases detected. An immediate change in the trend of using telemedicine was detected at the onset of outbreaks along with the surge of infection. The follow-up use of telemedicine services was not substantial among female, older adults patients and those with non-communicable diseases except mental health problems, and infectious diseases. Strategies need to be developed to reinforced healthcare resources for telemedicine during the surge of outbreaks and sustain the use of telemedicine services for chronic and infectious diseases, regardless of the pandemic, and promote the efficiency of healthcare systems.