Telehealth Use by Age and Race at a Single Academic Medical Center During the COVID-19 Pandemic: Retrospective Cohort Study

Abstract

Background During the COVID-19 pandemic, many ambulatory clinics transitioned to telehealth, but it remains unknown how this may have exacerbated inequitable access to care. Objective Given the potential barriers faced by different populations, we investigated whether telehealth use is consistent and equitable across age, race, and gender. Methods Our retrospective cohort study of outpatient visits was conducted between March 2 and June 10, 2020, compared with the same time period in 2019, at a single academic health center in Boston, Massachusetts. Visits were divided into in-person visits and telehealth visits and then compared by racial designation, gender, and age. Results At our academic medical center, using a retrospective cohort analysis of ambulatory care delivered between March 2 and June 10, 2020, we found that over half (57.6%) of all visits were telehealth visits, and both Black and White patients accessed telehealth more than Asian patients. Conclusions Our findings indicate that the rapid implementation of telehealth does not follow prior patterns of health care disparities.

Trends in the Utilization of Teleneurology and Other Healthcare Resources Prior to and During the COVID-19 Pandemic in an Urban, Tertiary Health System

“…Similar studies in non-neurological populations (10,(22)(23)(24)(25)(26)(27)(28) have shown consistent results with ours, with one study from a large urban health system demonstrating that socially vulnerable populations were more likely to use ED care and office visits in favor of telemedicine care (10). It is interesting to note that multiple studies conducted prior to the COVID-19 pandemic have found that minority status was associated with increased odds of telemedicine utilization in comparison to White patient groups, (29)(30)(31) suggesting that our findings may be in part related to the extraordinary nature of the COVID-19 public health emergency. Nonetheless, taken together with results from previous studies, our findings underscore the presence of important asymmetries in TN access for traditionally disadvantaged patient populations during the COVID pandemic.…”

Patient, physician, and policy factors underlying variation in use of telemedicine for radiation oncology cancer care

“…A recent study by Stevens et al of a general patient sample showed that older patients were more likely to use telehealth in visits during the early COVID-19 pandemic, though in that study, they were less likely to use video technology than younger patients. 45 Caregivers are frequently present for cancer patients and may be an important support for helping older patients to use telemedicine.…”

Impact of COVID-19 pandemic on STEMI undergoing primary PCI treatment in Beijing, China

“…COVID-19 has inevitable impact for medical care of other systemic diseases, especially the cardiovascular disease [ 3 ]. During the COVID-19 pandemic, many hospitals gave priority to treating COVID-19 patients and even reduced in-person ambulatory care [ 4 ]. Moreover, screening for COVID-19 will delay the time of management.…”