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Pre-existing Disparities and Potential Implications for the Rapid Expansion of Telemedicine in Response to the Coronavirus Disease 2019 Pandemic.
- Source :
-
Medical care [Med Care] 2021 Aug 01; Vol. 59 (8), pp. 694-698. - Publication Year :
- 2021
-
Abstract
- Background: Concerns exist regarding exacerbation of existing disparities in health care access with the rapid implementation of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. However, data on pre-existing disparities in telemedicine utilization is currently lacking.<br />Objective: We aimed to study: (1) the prevalence of outpatient telemedicine visits before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income; and (2) associated diagnosis categories.<br />Research Design: This was a retrospective cohort study.<br />Subject: Commercial claims data from the Truven MarketScan database (2014-2018) representing n=846,461,609 outpatient visits.<br />Measures: We studied characteristics and utilization of outpatient telemedicine services before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income. Disparities were assessed in unadjusted and adjusted (regression) analyses.<br />Results: With overall telemedicine uptake of 0.12% (n=1,018,092/846,461,609 outpatient visits) we found that pre-COVID-19 disparities in telemedicine use became more pronounced over time with lower use in patients who were older, had more comorbidities, were in rural areas, and had lower median household incomes (all trends and effect estimates P<0.001).<br />Conclusion: These results contextualize pre-existing disparities in telemedicine use and are crucial in the monitoring of potential disparities in telemedicine access and subsequent outcomes after the rapid expansion of telemedicine during the COVID-19 pandemic.<br />Competing Interests: The authors declare no conflict of interest.<br /> (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Adult
COVID-19 epidemiology
Humans
Infection Control trends
Male
Middle Aged
Patient Satisfaction statistics & numerical data
Quality Improvement
Retrospective Studies
Ambulatory Care trends
COVID-19 therapy
Health Services Accessibility trends
Healthcare Disparities statistics & numerical data
Telemedicine trends
Subjects
Details
- Language :
- English
- ISSN :
- 1537-1948
- Volume :
- 59
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Medical care
- Publication Type :
- Academic Journal
- Accession number :
- 34054024
- Full Text :
- https://doi.org/10.1097/MLR.0000000000001585