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Disparities in telephone and video telehealth engagement during the COVID-19 pandemic.
Sachs, Jonathan W; Graven, Peter; Gold, Jeffrey A; Kassakian, Steven Z.
Afiliación
  • Sachs JW; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
  • Graven P; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
  • Gold JA; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
  • Kassakian SZ; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
JAMIA Open ; 4(3): ooab056, 2021 Jul.
Article en En | MEDLINE | ID: mdl-34632322
OBJECTIVE: The COVID-19 pandemic and subsequent expansion of telehealth may be exacerbating inequities in ambulatory care access due to institutional and structural barriers. We conduct a repeat cross-sectional analysis of ambulatory patients to evaluate for demographic disparities in the utilization of telehealth modalities. MATERIALS AND METHODS: The ambulatory patient population at Oregon Health & Science University (Portland, OR, USA) is examined from June 1 through September 30, in 2019 (reference period) and in 2020 (study period). We first assess for changes in demographic representation and then evaluate for disparities in the utilization of telephone and video care modalities using logistic regression. RESULTS: Between the 2019 and 2020 periods, patient video utilization increased from 0.2% to 31%, and telephone use increased from 2.5% to 25%. There was also a small but significant decline in the representation males, Asians, Medicaid, Medicare, and non-English speaking patients. Amongst telehealth users, adjusted odds of video participation were significantly lower for those who were Black, American Indian, male, prefer a non-English language, have Medicaid or Medicare, or older. DISCUSSION: A large portion of ambulatory patients shifted to telehealth modalities during the pandemic. Seniors, non-English speakers, and Black patients were more reliant on telephone than video for care. The differences in telehealth adoption by vulnerable populations demonstrate the tendency toward disparities that can occur in the expansion of telehealth and suggest structural biases. CONCLUSION: Organizations should actively monitor the utilization of telehealth modalities and develop best-practice guidelines in order to mitigate the exacerbation of inequities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Qualitative_research Aspecto: Equity_inequality Idioma: En Revista: JAMIA Open Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Qualitative_research Aspecto: Equity_inequality Idioma: En Revista: JAMIA Open Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos