Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Cantor JH

PROVIDER: S-EPMC7936544 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Introduction: The COVID-19 pandemic has affected health care services worldwide due to lockdowns, prevention measures, and social distancing. During this period, patients, including older adults and those with chronic conditions, need ways to obtain medical attention other than going physically to the clinic, such as telemedicine services. The purpose of the present study was to evaluate attitudes toward telemedicine during the COVID-19 lockdown in Israel, assess willingness to use such services in the future, and evaluate the extent to which consumers have changed their minds regarding these services. Method: A cross-sectional, descriptive, correlational study was conducted among adults (age 20-90) using social media networks (N = 693). Data were collected using an online questionnaire explicitly designed to measure attitudes toward telemedicine. Results: Most of the participants had to use telemedicine during the lockdown and were satisfied therewith. The majority also stated that they would continue using telemedicine in the future. However, only a third stated that they had changed their minds regarding telemedicine. The main predictors of willingness to use telemedicine in the future were the necessity of using such services during lockdown, preference for going to a clinic, and satisfaction with telemedicine, alongside gender and having a chronic illness. Importantly, we found that a preference for visiting the clinic was negatively correlated with willingness to use telemedicine in the future. Education and being single were predictors of the change of mind regarding telemedicine. Participants with chronic conditions are more likely to use these services, and specific attention should be directed to their needs. A small portion of the study sample prefers live appointments with a physician. Conclusions: Telemedicine use is rapidly changing. It is vital for health care providers to identify non-telemedicine users and their common characteristics. Monitoring patients' attitudes regarding telemedicine is essential in the future after the pandemic ends. Targeted outreach plans should be formulated. These plans should be directed at identifying barriers to using telemedicine, and they should generate specific, focused plans.