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Showing content from https://pubmed.ncbi.nlm.nih.gov/33471458/ below:

Differences in the use of telephone and video telemedicine visits during the COVID-19 pandemic

doi: 10.37765/ajmc.2021.88573. Differences in the use of telephone and video telemedicine visits during the COVID-19 pandemic

Affiliations

Affiliation

¹ Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA 02120. Email: jarodriguez1@partners.org.

PMID: 33471458
PMCID: PMC10877492
DOI: 10.37765/ajmc.2021.88573

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Differences in the use of telephone and video telemedicine visits during the COVID-19 pandemic

Jorge A Rodriguez et al. Am J Manag Care. 2021 Jan.

doi: 10.37765/ajmc.2021.88573. Affiliation

¹ Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA 02120. Email: jarodriguez1@partners.org.

PMID: 33471458
PMCID: PMC10877492
DOI: 10.37765/ajmc.2021.88573

Item in Clipboard

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic forced health systems to offer video and telephone visits as in-person visit alternatives. Although video visits offer some benefits compared with telephone visits, they require complex setup, which may disadvantage some patients due to the "digital divide." Our objective was to determine patient and neighborhood characteristics associated with visit modality.

Study design: This was a cross-sectional study across 1652 primary care and specialty care practices of adult patients at an integrated health system from April 23 to June 1, 2020.

Methods: We used electronic health record and administrative data. Our primary outcome was visit modality (in-person, video, or telephone), which was captured using billing codes. We assessed predictors of using video vs telephone using multivariable logistic regression. We used hierarchical logistic regression to determine the contribution of patient-, physician-, and practice-level components of variance in the choice of video or telephone visits.

Results: We analyzed 231,596 visits by 162,102 patients. Sixty-five percent of the visits were virtual (31.7% telephone, 33.5% video). Patients who were older than 65 years (adjusted odds ratio [AOR], 0.41; 95% CI, 0.40-0.43), Black (AOR, 0.60; 95% CI, 0.57-0.63), Hispanic (AOR, 0.76; 95% CI, 0.73-0.80), Spanish-speaking (AOR, 0.57; 95% CI, 0.52-0.61), and from areas with low broadband access (AOR, 0.93; 95% CI, 0.88-0.98) were less likely to use video visits. Practices (38%) and clinicians (26%) drove more of the variation in video visit use than patients (9%).

Conclusions: Telemedicine access differences may compound disparities in chronic disease and COVID-19 outcomes. Institutions should monitor video visit use across demographics and equip patients, clinicians, and practices to promote telemedicine equity.

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Conflict of interest statement

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Figures
FIGURE 1.. Trends in Visit Type (March…

FIGURE 1.. Trends in Visit Type (March 1-June 1, 2020) ^a

^a Excludes ambiguous encounters.

FIGURE 1.. Trends in Visit Type (March 1-June 1, 2020)^a

^aExcludes ambiguous encounters.

FIGURE 2.. Trend in Video Visit Use…

FIGURE 2.. Trend in Video Visit Use by Patient Demographics ^a

^a Y-axis represents proportion of…

FIGURE 2.. Trend in Video Visit Use by Patient Demographics^a

^aY-axis represents proportion of all telemedicine visits that were video visits.

FIGURE 3.. Association of Telemedicine Vist Type…

FIGURE 3.. Association of Telemedicine Vist Type With Patient- and Zip Code-Level Factors ^a

^a Excludes…

FIGURE 3.. Association of Telemedicine Vist Type With Patient- and Zip Code-Level Factors^a

^aExcludes ambiguous encounters. *** P < .001.

Comment in

Telehealth Disparities: The Authors Reply.
Rodriguez JA, Bates DW, Samal L, Saadi A, Schwamm LH. Rodriguez JA, et al. Health Aff (Millwood). 2021 Aug;40(8):1340. doi: 10.1377/hlthaff.2021.01041. Health Aff (Millwood). 2021. PMID: 34339238 No abstract available.
Telehealth Disparities.
Payán DD, Rodriguez HP. Payán DD, et al. Health Aff (Millwood). 2021 Aug;40(8):1340. doi: 10.1377/hlthaff.2021.00940. Health Aff (Millwood). 2021. PMID: 34339248 No abstract available.