Disparities in telemedicine utilization among surgical patients during COVID-19.

Autor: Lattimore CM; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Kane WJ; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Fleming MA 2nd; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Martin AN; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America., Mehaffey JH; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Smolkin ME; Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America., Ratcliffe SJ; Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America., Zaydfudim VM; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Showalter SL; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America., Hedrick TL; Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Oct 08; Vol. 16 (10), pp. e0258452. Date of Electronic Publication: 2021 Oct 08 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0258452
Abstrakt: Background: Telemedicine has been rapidly adopted in the wake of the COVID-19 pandemic. There is limited work surrounding demographic and socioeconomic disparities that may exist in telemedicine utilization. This study aimed to examine demographic and socioeconomic differences in surgical patient telemedicine usage during the COVID-19 pandemic.
Methods: Department of Surgery outpatients seen from July 1, 2019 to May 31, 2020 were stratified into three visit groups: pre-COVID-19 in-person, COVID-19 in-person, or COVID-19 telemedicine. Generalized linear models were used to examine associations of sex, race/ethnicity, Distressed Communities Index (DCI) scores, MyChart activation, and insurance status with telemedicine usage during the COVID-19 pandemic.
Results: 14,792 patients (median age 60, female [57.0%], non-Hispanic White [76.4%]) contributed to 21,980 visits. Compared to visits before the pandemic, telemedicine visits during COVID-19 were more likely to be with patients from the least socioeconomically distressed communities (OR, 1.31; 95% CI, 1.08,1.58; P = 0.005), with an activated MyChart (OR, 1.38; 95% CI, 1.17-1.64; P < .001), and with non-government or commercial insurance (OR, 2.33; 95% CI, 1.84-2.94; P < .001). Adjusted comparison of telemedicine visits to in person visits during COVID-19 revealed telemedicine users were more likely to be female (OR, 1.38, 95% CI, 1.10-1.73; P = 0.005) and pay with non-government or commercial insurance (OR, 2.77; 95% CI, 1.85-4.16; P < .001).
Conclusions: During the first three months of the COVID-19 pandemic, telemedicine was more likely utilized by female patients and those without government or commercial insurance compared to patients who used in-person visits. Interventions using telemedicine to improve health care access might consider such differences in utilization.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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