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Equity and Inclusion in Pediatric Gastroenterology Telehealth: A Study of Demographic, Socioeconomic, and Digital Disparities.
Mougey, Edward B; Judy, Wesley C; Venkatesh, Rajitha D; Berg, Elizabeth; Lee, Jennifer A; Rosen, John M; Li, B U K; Koster, Alex; Maiden, Kristin; Gao, Zhongcui; Franciosi, James P.
Afiliación
  • Mougey EB; From Nemours Children's Health Care System, Jacksonville, FL.
  • Judy WC; the Department of Pediatrics, Nemours Children's Hospital, Orlando, FL.
  • Venkatesh RD; Nationwide Children's Hospital, Columbus, OH.
  • Berg E; The Ohio State University, Columbus, OH.
  • Lee JA; Columbia University, New York, NY.
  • Rosen JM; Nationwide Children's Hospital, Columbus, OH.
  • Li BUK; The Ohio State University, Columbus, OH.
  • Koster A; the Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO.
  • Maiden K; the Department of Pediatrics, University of Missouri - Kansas City, Kansas City, MO.
  • Gao Z; Medical College of Wisconsin, Milwaukee, WI.
  • Franciosi JP; Nemours Value Based Services Organization, Jacksonville, FL.
J Pediatr Gastroenterol Nutr ; 77(3): 319-326, 2023 09 01.
Article en En | MEDLINE | ID: mdl-37079871
OBJECTIVES: The purpose of our study is to compare in-person and telehealth pediatric care ambulatory visits for gastroenterology (GI) at the Nemours Children's Health System in the Delaware Valley (NCH-DV) based on geospatial, demographic, socioeconomic, and digital disparities. METHODS: Characteristics of 26,565 patient encounters from January 2019 to December 2020 were analyzed. U.S. Census Bureau geographic identifiers were assigned to each participant and aligned with the American Community Survey (2015-2019) socioeconomic and digital outcomes. Reported odds ratios (OR) are telehealth encounter/in-person encounter. RESULTS: GI telehealth usage increased 145-fold in 2020 compared to 2019 for NCH-DV. Comparing telehealth to in-person usage in 2020 revealed that GI patients who required a language translator were 2.2-fold less likely to choose telehealth [individual level adjusted OR (I-OR a ) [95% confidence interval, CI], 0.45 [0.30-0.66], P < 0.001]. Individuals of Hispanic ethnicity or non-Hispanic Black or African American race are 1.3-1.4-fold less likely to utilize telehealth than non-Hispanic Whites (I-OR a [95% CI], 0.73 [0.59-0.89], P = 0.002 and 0.76 [0.60-0.95], P = 0.02, respectively). Households in census block groups (BG) that are more likely to utilize telehealth: have broadband access (BG-OR = 2.51 [1.22-5.31], P = 0.014); are above the poverty level (BG-OR = 4.44 [2.00-10.24], P < 0.001); own their own home (BG-OR = 1.79 [1.25-2.60], P = 0.002); and have a bachelor's degree or higher (BG-OR = 6.55 [3.25-13.80], P < 0.001). CONCLUSIONS: Our study is the largest reported pediatric GI telehealth experience in North America that describes racial, ethnic, socioeconomic, and digital inequities. Advocacy and research for pediatric GI focused on telehealth equity and inclusion is urgently needed.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / Disparidades en Atención de Salud / Gastroenterología Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / Disparidades en Atención de Salud / Gastroenterología Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos