Telehealth appointments soared during the pandemic, but non-white Americans were less likely to use ... [+]
Telemedicine, where healthcare is delivered via “virtual” routes such as phone or video calls, has soared in use and popularity during the Covid-19 pandemic. This is largely due to healthcare providers trying to keep their patients safe by reducing any non-essential in-person visits and has also been aided by emergency waivers to allow providers to provide telehealth visits.
Telemedicine has often been touted as an advance which will help reduce disparities in access to care, but a new study led by researchers at the University of Houston (UH) College of Medicine suggests that this has not been the case throughout the pandemic so far.
“We found that racial and ethnic disparities persisted,” said lead study author Omolola Adepoju, MPH, PhD, a clinical associate professor at the UH College of Medicine and director of research at the Humana Integrated Health Sciences Institute at UH. “This suggests that the promise of the positive impact of telemedicine on health care use and health outcomes could elude underserved populations,” Adepoju added.
The research was published in the Journal of General Internal Medicine and used data from medical records from 55 clinics in Texas collected between March and November 2020. Overall, almost a quarter of a million medical visits were analyzed from 67,733 patients, with the research finding that African Americans were 35% less likely to use telemedicine than white Americans. Hispanic people were 51% less likely than white people to have a telemedicine visit and Asian people and American Indian/Alaska Natives and Pacific Islanders were also less likely to use telemedicine.
The study concluded a few factors were responsible for these disparities, including lack of access to technologies which are required for telehealth appointments.
“The people who really need to access their primary care providers might be cut out [of telemedicine] because they don’t have the technology or might not know how to use it,” said Adepoju, adding that 66% of African American and 61% of Hispanic households have access to broadband internet, compared to 79% of white households.
The study also found that uninsured people or those covered by Medicaid were less likely to have a telemedicine appointment and both young people under 18 and older adults were less likely to use telemedicine than middle-aged adults. However, the research did find that the further away someone lived from their clinic, the more likely they were to use telemedicine and that this held true for African American and Hispanic patients too.
“We observed a dose-response to geographic distance so that the further a patient lived, the higher the likelihood of telemedicine use,” Adepoju said.
As some pandemic restrictions lift and some patients are opting to return to in-person care, telemedicine is likely to continue to be available to many people. Adepoju hopes that patients are supported so that they can take advantage of telemedicine.
“Clinics will need a technology support system. Staff that conduct pre-visit device and connectivity testing with patients can be instrumental to helping patients maximize telemedicine as an access to care option,” said Adepoju.
