Telehealth used less in disadvantaged areas, Health Affairs study finds

A Wellness Affairs study located that telemedicine use during the COVID-19 pandemic was decreased in communities with higher rates of poverty – suggesting that the field ought to address the digital divide in get to make sure popular obtain to digital treatment.

The study, which was executed by scientists from Harvard and the RAND Corporation, examined the variation in complete outpatient visits and telemedicine use amid sixteen.7 million commercially insured and Medicare Gain enrollees from January by way of June 2020.  

“While the boost in telemedicine use during the pandemic is broadly acknowledged, it is unclear how the use of telemedicine and in-individual treatment has various across affected person demographics, clinical specialties, and health-related problems,” wrote the research workforce.  

Throughout the COVID-19 period of time of the study, scientists located that 30.1% of complete visits have been provided via telemedicine – with a whopping 20-three-fold boost in weekly number of telemedicine visits, as opposed to the pre-COVID-19 period of time.   

Nonetheless, overall pay a visit to volume diminished by 35%, boosting concerns about the effect of deferred treatment in the foreseeable future.  

WHY IT Issues

Telehealth has been hailed as a panacea for unequal obtain to treatment, but the info has continuously proposed normally.

Researchers located that the proportion of complete visits provided via telemedicine was smallest amid those people more mature than 65. Rural counties also saw decreased percentages of telemedicine use when as opposed to urban counties.

When it comes to clinical specialties, the study located that prior to March seventeen, 2020, fewer than two% of clinicians in each and every specialty shipped any outpatient treatment via telemedicine, with the exception of psychological health and fitness clinicians.

Throughout the COVID-19 period of time, psychiatrists, gastroenterologists, endocrinologists and social workers provided additional than 50 percent of their visits virtually, with psychologists and neurologists not considerably powering.  

By distinction, specialties these kinds of as ophthalmology dropped most of their clinical volume early in the pandemic.  

“While there was variability in the magnitude of variations across diverse affected person populations and clinical disciplines, each and every section of the health and fitness treatment process seasoned a fall in the overall volume of treatment, together with vital prevalent chronic problems these kinds of as diabetic issues and hypertension,” wrote the scientists.

Researchers also pointed out decreased telemedicine use in substantial-poverty regions, even though also flagging that the study population disproportionately integrated used grown ups and their spouse and children users with industrial insurance. In a separate Wellness Affairs blog site, health and fitness plan gurus pointed out that Medicaid users have had “fewer regular” obtain to telemedicine.  

THE Larger sized Development  

As issues linger about the foreseeable future of telehealth amid a continuing pandemic, scientists and advocates are analyzing which men and women have benefited from expanded obtain – and who has been remaining powering.

A broad-ranging study published in December located that more mature men and women, ladies, Black and Latinx people today and patients with decreased family incomes have been fewer most likely to use online video for telemedicine treatment, and that more mature patients, Asian men and women and non-English-talking men and women had decreased rates of finished telehealth visits.

“We ought to be intentional with implementation to make sure that all patients are geared up to proficiently participate in telemedicine treatment,” wrote the scientists in that study.  

ON THE Report  

“Our analyses, replicated at the health and fitness process degree, could notify plan to make up for months of deferred treatment,” said Wellness Affairs scientists.

“Wellness devices could allocate methods to affected person outreach endeavours these kinds of as telephone phone calls or reminder messages, prioritizing patients whose problems saw the premier fall in pay a visit to volume. Also, further clinical capacity could be allocated to specialties with the premier backlogs of deferred treatment,” they wrote.

“Lastly, health and fitness devices could prioritize chronic sickness populations, who have been additional most likely to have deferred treatment, for targeted population administration.”

Kat Jercich is senior editor of Health care IT Information.
Twitter: @kjercich
E mail: [email protected]
Health care IT Information is a HIMSS Media publication.