Safety of Telemedicine Versus In-Person Care for Patients With Tracheal Devices: Propensity Score–Matched Cohort Study

Background: Patients with tracheal diseases often require long-term follow-up after tracheal device placement, with a risk of adverse events that may lead to emergency care and unplanned interventions. Telemedicine has been proposed as an alternative to in-person follow-up to improve access and continuity of care. Objective: The primary objective of this study was to compare the need for emergency department (ED) visits between telemedicine and in-person groups. Secondary objectives included comparing hospital readmissions, 30-day hospital readmissions, and unplanned interventions between groups. Methods: This retrospective, single-institution study included adult patients with tracheal devices who underwent telemedicine and in-person outpatient clinic visits between 2020 and 2024. To balance the groups, we used 1:1 propensity score matching. We collected demographic and clinical data and evaluated the need for ED visits, hospital readmissions, 30-day hospital readmissions, and unplanned interventions. Kaplan-Meier estimation of time to first ED visit was performed to assess outcomes after outpatient visits. Results: A total of 483 patients (n=277, 57% telemedicine and n=206, 43% in-person) underwent 2487 visits (1258 telemedicine and 1229 in-person). After propensity score matching, 336 patients remained (168 in each group). There were no significant differences in the need for ED visits, hospital readmissions, or unplanned interventions. The telemedicine group had significantly fewer 30-day hospital readmissions (odds ratio 0.38, 95% CI 0.16-0.87; =.02). Kaplan-Meier analysis indicated no statistically significant difference in ED-free visits. Conclusions: Telemedicine follow-up was associated with outcomes comparable to those of in-person follow-up in this cohort of adult patients with tracheal devices, with no evidence of an increased need for ED visits. In the matched analysis, telemedicine was associated with lower odds of 30-day hospital readmission.