Predictors of Audio-Only Versus Video Telehealth Visits During the COVID-19 Pandemic

Chen, Julia; Li, Kathleen; Andino, Juan J.; Hill, Chloé E.; Ng, Sophia; Steppe, Emma; Ellimoottil, Chad

doi:10.1007/s11606-021-07172-y

Cited by 49 publications

(53 citation statements)

References 10 publications

(12 reference statements)

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“…Our findings suggest that non-white patients, patients with Medicaid and public insurance, unemployed patients, and those of the lowest quartile of household income are a vulnerable group in this pandemic landscape, with decreased telehealth use and increased missed visit rates. There are several studies in the current literature which have also found decreased telehealth use rates among non-white subjects, Medicaid or Medicare insurance, and single status individuals 5–7 16. This decrease in telehealth use can also be attributed to the aforementioned digital divide.…”

Section: Discussionmentioning

confidence: 88%

“…in inequities in using the telehealth at the start of the pandemic. [4][5][6][7] However, while these studies have looked at healthcare access disparities during the first surge of COVID-19, they have not examined whether these trends in healthcare access have persisted in 2021, after the country had adequate time to become accustomed to the pandemic landscape. Consequently, the true gravity of these healthcare access disparities has not been accurately measured.…”

Section: Original Researchmentioning

confidence: 99%

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Temporal Trends and Disparities in Gastroenterology Care use before, during, and after COVID-19 Lockdown

Sanaka

Garg

Patel

et al. 2022

Journal of Investigative Medicine

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Socioeconomic disparities adversely affected healthcare use during COVID-19 lockdown. However, trends in these disparities post lockdown are unknown. Therefore, our aim was to study temporal trends and factors associated with gastroenterology healthcare access and disparities during and after COVID-19 lockdown. This cohort study consisted of patients receiving outpatient care in the Cleveland Clinic gastroenterology department between March 2020 and June 2020 and corresponding time periods in 2019 and 2021. Patient demographics and socioeconomic factors were extracted and analyzed. There were 47,031 patients (mean age 56.3±17.6 years, 61.9% female and 76.4% white) included. Patients ≥65 years sought healthcare less frequently during and after the lockdown (40.1% vs 34.8% vs 35.2% in 2019, 2020, and 2021 respectively). Missed visits (4.2% vs 10% vs 10.4%), tobacco (11.4% vs 15.9% vs 16.1%), alcohol (38.6% vs 45.5% vs 50.9%), and illicit drug use (3.5% vs 5.8% vs 10.7%) have steadily increased during and after the lockdown compared with prepandemic levels. Factors associated with reduced telehealth use were black race (OR 0.89, 95% CI 0.81 to 0.99), Hispanic race (OR 0.63, 95% CI 0.51 to 0.77)), Medicaid/other public insurance (OR 0.87, 95% CI 0.79 to 0.95)), unemployed status (OR 0.85, 95% CI 0.79 to 0.92)), and non-English/Spanish speakers (OR 0.66, 95% CI 0.46 to 0.94)). In conclusion, socioeconomic and ethnic disparities persist in healthcare use even a year after the onset of the COVID-19 pandemic. There is an alarming increase in missed visits and substance abuse. Therefore, efforts should be targeted on improving healthcare access for these aforementioned vulnerable groups.

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Section: Discussionmentioning

confidence: 88%

Section: Original Researchmentioning

confidence: 99%

Temporal Trends and Disparities in Gastroenterology Care use before, during, and after COVID-19 Lockdown

Sanaka

Garg

Patel

et al. 2022

Journal of Investigative Medicine

View full text Add to dashboard Cite

show abstract

“… 29 , 30 Others argue that audio‐only visits allow individuals who would otherwise not receive care a way to do so. 12 , 27 , 31 , 32 , 33 Importantly greater access to care has been associated with improved patient survival and outcomes. 34 While a study found that telemedicine was associated with a slight increase (<1.5% increase) in follow‐up office visits than in‐person care; there were fewer lab tests and prescriptions ordered after telemedicine and there were no differences in hospitalizations or emergency department visits compared to in‐person visits.…”

Section: Discussionmentioning

confidence: 99%

Older adults' perspectives on primary care telemedicine during the COVID‐19 pandemic

Bhatia

Gilliam

Aliberti

et al. 2022

J American Geriatrics Society

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Background Prior to the COVID‐19 pandemic there were many barriers to telemedicine primary care for adults ≥65 years including insurance coverage restrictions and having lower digital access and literacy. With the pandemic, insurance coverage broadened and many older adults utilized telemedicine creating an opportunity to learn from their experiences to inform future policy. Methods Between April 2020 and June 2021, we conducted a cross‐sectional multimethod study of English‐speaking, cognitively‐intact, adults ≥65, who had a phone‐only and/or video telemedicine visit with their primary care physician within one large Massachusetts health system (10 different practices) since March 2020. The study questionnaire asked participants their overall satisfaction with telemedicine (7‐point scale) and to compare telemedicine with in‐person care. We used linear regression to examine the association between participants' demographics, Charlson comorbidity score, and survey completion date with their satisfaction score. The questionnaire also included open‐ended questions on perceptions of telemedicine; which were analyzed using qualitative methods. Results Of 278 eligible patients reached, 208 completed the questionnaire; mean age was 74.4 years (±4.4), 61.5% were female, 91.4% were non‐Hispanic White, 64.4% had ≥1 comorbidity, and 47.2% had a phone‐only visit. Regardless of their age, participants reported being satisfied with telemedicine; median score was 6.0 on the 7‐point scale (25th percentile = 5.0 and 75th percentile = 7.0). Non‐Whites satisfaction scores were on average 1 point lower than those of non‐Hispanic Whites ( p = 0.02). Those with comorbidity reported scores that on average were 0.5 points lower than those without comorbidity ( p = 0.07). Overall, 39.5% felt their telemedicine visit was worse than in‐person care; 4.9% thought it was better. Participants appreciated telemedicine's convenience but described frustrating technical challenges. While participants preferred in‐person care, most wanted telemedicine to remain available. Conclusions Adults ≥65 reported being satisfied with primary care telemedicine during the pandemic's first 14 months and wanted telemedicine to remain available.

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“…40 It should be noted that video-based telemedicine is not readily accessible to certain populations such as those living in areas without high-speed broadband and those with limited digital and English proficiency. 41 As a result, payers should also incentivize voice-only telehealth on equal footing to maximize quality and convenience for those with lower broadband access or who prefer telephone use, respectively. Additionally, we recommend that telemedicine and remote care platforms adhere to existing standards for linguistically and culturally appropriate services in health care.…”

Section: Potential Solutionsmentioning

confidence: 99%

Prescriptions for Mitigating Climate Change–Related Externalities in Cancer Care: A Surgeon's Perspective

Agbafe

Berlin

Butler

et al. 2022

JCO

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Predictors of Audio-Only Versus Video Telehealth Visits During the COVID-19 Pandemic

Cited by 49 publications

References 10 publications

Temporal Trends and Disparities in Gastroenterology Care use before, during, and after COVID-19 Lockdown

Temporal Trends and Disparities in Gastroenterology Care use before, during, and after COVID-19 Lockdown

Older adults' perspectives on primary care telemedicine during the COVID‐19 pandemic

Prescriptions for Mitigating Climate Change–Related Externalities in Cancer Care: A Surgeon's Perspective

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