Article ; Online: Socioeconomic and Demographic Disparities in the Use of Telemedicine for Ophthalmic Care during the COVID-19 Pandemic.
2021 Volume 129, Issue 1, Page(s) 15–25
Abstract: Purpose: To identify disparities in the use of telemedicine during the coronavirus disease 2019 ... 19 on minorities, it will be increasingly important to identify barriers to telehealth use and ... telehealth encounter. With the expansion of telemedicine and the need to reduce the disparate impact of COVID ...
| Abstract | Purpose: To identify disparities in the use of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. Design: A cross-sectional study of completed clinical encounters in an academic ophthalmology center from March 2020 through August 2020. Participants: A total of 5023 patients comprising 8116 ophthalmic clinical encounters. Methods: Medical charts were abstracted for demographic information. We identified zip code-level socioeconomic characteristics, which were drawn from the 2019 American Community Survey 5-year estimates. Main outcome measures: The completion of a synchronous video encounter, the completion of a telephone (audio-only) encounter in the absence of any video encounters, or the completion of in-person encounters only. Results: During the study period, 8116 total clinical encounters were completed for 5023 unique patients. Of these patients, 446 (8.9%) participated in a video encounter, 642 (12.8%) completed a telephone encounter, and 3935 (78.3%) attended clinical appointments in person only. In adjusted analysis, patients who were Black (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.52-0.80; P < 0.001) or Hispanic/Latino (OR, 0.65; 95% CI, 0.49-0.85; P = 0.002) were significantly less likely to complete a video or telephone appointment. Older patients (OR, 0.99; 95% CI, 0.98-0.99; P < 0.001), patients whose primary language was not English (OR, 0.49; 95% CI, 0.28-0.82; P = 0.01), Black patients (OR, 0.45; 95% CI, 0.32-0.62; P < 0.001), and Hispanic/Latino patients (OR, 0.56; 95% CI, 0.37-0.83; P = 0.005) were significantly less likely to complete a video encounter. Finally, among patients completing any type of telemedicine encounter, older age, (OR, 1.02; 95% CI, 1.01-1.03; P < 0.001), Medicare insurance (OR, 1.55; 95% CI, 1.11-2.17; P = 0.01), and Black race (OR, 1.97; 95% CI, 1.33-2.94; P < 0.001) were associated with using only phone visits. Conclusions: Ethnic/racial minorities, older patients, and non-English-speaking individuals were significantly less likely to complete a video telehealth encounter. With the expansion of telemedicine and the need to reduce the disparate impact of COVID-19 on minorities, it will be increasingly important to identify barriers to telehealth use and opportunities to improve access. |
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| MeSH term(s) | Adult ; Aged ; Aged, 80 and over ; Appointments and Schedules ; COVID-19/epidemiology ; Cross-Sectional Studies ; Delivery of Health Care/statistics & numerical data ; Ethnic and Racial Minorities/statistics & numerical data ; Female ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Humans ; Male ; Medicare/statistics & numerical data ; Middle Aged ; Minority Groups/statistics & numerical data ; Ophthalmology/statistics & numerical data ; Retrospective Studies ; SARS-CoV-2 ; Socioeconomic Factors ; Telemedicine/statistics & numerical data ; Telephone ; United States/epidemiology ; Young Adult | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-07-08 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Journal Article | ||||||||||
| ZDB-ID | 392083-5 | ||||||||||
| ISSN | 1549-4713 ; 0161-6420 | ||||||||||
| ISSN (online) | 1549-4713 | ||||||||||
| ISSN | 0161-6420 | ||||||||||
| DOI | 10.1016/j.ophtha.2021.07.003 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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