Prior institutional contact and hospitalization risk after telemedicine visits for acute respiratory infections

The rapid expansion of telemedicine during the COVID-19 pandemic increased telemedicine consultations without prior contact to the same medical institution, raising concerns about continuity of care. This study examined whether prior institutional contact was associated with hospitalization after telemedicine visits for acute respiratory infections. Using a nationwide claims database in Japan, we conducted a retrospective cohort study of 189,377 initial telemedicine visits between April 2020 and April 2024. Prior institutional contact was defined as at least one visit to the same institution in the preceding 12 months. The primary outcome was all-cause hospitalization within 14 days. Overall, 24.7% of visits involved prior institutional contact; hospitalization occurred in 0.4% of these visits and 0.9% of visits without prior contacts. Prior institutional contact was associated with a lower hospitalization risk (adjusted risk ratio, 0.71; 95% CI, 0.58–0.87). These findings suggest the potential importance of prior institutional contact when selecting a provider for initial telemedicine consultations for acute respiratory infections.