Who Is (and Is Not) Receiving Telemedicine Care During the COVID-19 Pandemic

Autor: Megan F Pera, Christopher M. Whaley, Ryan K. McBain, Dena M. Bravata, Jonathan Cantor
Rok vydání: 2021
Předmět:
Zdroj: American Journal of Preventive Medicine
ISSN: 0749-3797
DOI: 10.1016/j.amepre.2021.01.030
Popis: Introduction The COVID-19 pandemic has forced telehealth to be the primary means through which patients interact with their providers. There is a concern that the pandemic will exacerbate the existing disparities in overall healthcare utilization and telehealth utilization. Few national studies have examined the changes in telehealth use during the COVID-19 pandemic. Methods Data on 6.8 and 6.4 million employer-based health plan beneficiaries in 2020 and 2019, respectively, were collected in 2020. Unadjusted rates were compared both before and after the week of the declaration of the COVID-19 pandemic as a national emergency. Trends in weekly utilization were also examined using a difference-in-differences regression framework to quantify the changes in telemedicine and office-based care utilization while controlling for the patient's demographic and county-level sociodemographic measures. All analyses were conducted in 2020. Results More than a 20-fold increase in the incidence of telemedicine utilization after March 13, 2020 was observed. Conversely, the incidence of office-based encounters declined by almost 50% and was not fully offset by the increase in telemedicine. The increase in telemedicine was greatest among patients in counties with low poverty levels (β=31.70, 95% CI=15.17, 48.23), among patients in metropolitan areas (β=40.60, 95% CI=30.86, 50.34), and among adults than among children aged 0–12 years (β=57.91, 95% CI=50.32, 65.49). Conclusions The COVID-19 pandemic has affected telehealth utilization disproportionately on the basis of patient age and both the county-level poverty rate and urbanicity.
Databáze: OpenAIRE
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