Evaluation of a telemedicine pilot project for hypertension in Korea: a nationwide real-world data study

Abstract

OBJECTIVES: A telemedicine pilot project has received temporary authorization in Korea. The clinical effectiveness of telemedicine is well established; however, ongoing research must assess medical utilization, sustainability, prescription continuity, and safety.METHODS: This study evaluated medical utilization, sustainability, prescription continuity, and safety before and after the implementation of a telemedicine pilot project between June 2022 and December 2023. Data were obtained from the Korean National Health Insurance Service (NHIS), and participants were divided into those who received non-face-to-face hypertension treatment at least once and those who did not.RESULTS: This study included 124,210 patients diagnosed with hypertension who received telemedicine (the Tele_G group) and 124,210 propensity score-matched control individuals. The difference-in-difference (DID) for medical utilization between the Tele_G and control groups was 0.10 (-0.03 vs. -0.12, p<0.001). The DID for the Modified Modified Continuity Index was -0.005 (-0.003 vs. 0.002, p<0.001), while that for Most Frequent Provider Continuity was -0.006 (-0.004 vs. 0.002, p<0.001). The DID for the prescription day rate was 0.41 (-0.61 vs. -1.02, p<0.001), and that for the appropriate prescription continuation rate was 0.52 (-1.23 vs. -1.75, p<0.01).CONCLUSIONS: Telemedicine did not fully achieve the same standard as face-to-face treatment for hypertension management; however, it showed comparable safety, suggesting potential as secondary care. As the first NHIS-based study on this topic in Korea, this research highlights the benefits of telemedicine when appropriately utilized for patients with hypertension. Nevertheless, due to limitations regarding long-term continuity and policy design, cautious interpretation is required, and further prospective studies are warranted.