The Impact of Telehealth Expansion on Health Care Utilization, Access, and Outcomes During the Pandemic: A Systematic Review.

Introduction: The COVID-19 pandemic brought unprecedented change to the health care industry, including a large and rapid shift to providing care through telehealth technologies. Although the expansion of telehealth services was successful in continuing to provide patients with care while preventing the spread of disease, it is less clear how patient sociodemographic characteristics influenced telehealth use during this time. This study aims to systematically review the published literature on demographic differences in telehealth access, utilization, and health outcomes among a variety of adult patient types in the United States. Methods: Litcovid, PubMed, Web of Science, and MEDLINE databases were searched, resulting in a final sample of n = 32 studies. Results: Results found that studies could be categorized as addressing at least one of eight different areas of inquiry: sociodemographic differences in telehealth use (1) during and (2) before the pandemic, telehealth use versus nonuse (3) during and (4) before the pandemic, (5) telehealth modality, (6) satisfaction with telehealth, (7) outcomes associated with telehealth use, and (8) perceived or actual access to telehealth services. Discussion: Findings are robust across included studies with respect to racial, age, and socioeconomic differences in telehealth utilization and health outcomes, reflecting sociodemographic differences in health care access, utilization, and outcomes more broadly that persist despite this expansion of telehealth services owing to COVID-19. Additional findings across studies are summarized and areas for future research are discussed.

Help-Seeking From Websites and Police in the Aftermath of Technology-Facilitated Victimization.

This study looked at experiences of help-seeking from websites and police following an episode of technology-facilitated abuse. It used data from a nationally representative online panel of adults aged 18 to 28, sampled from Ipsos Knowledge Panel. A total of 1,952 unique victimization episodes from childhood and adulthood were identified and used in analyses. Participants were asked about whether they experienced 11 different types of technology-facilitated abuse (TFA), whether the incident was reported to the website or police, barriers to reporting, and features of the website's or law enforcement's response. Other follow-up information included victim gender, age, relationship to the perpetrator, and negative emotional impact (NEI) associated with the incident. Results found very low rates of reporting to both websites (7.3%) and law enforcement (4.8%). Image-based offenses had higher rates of reporting. A greater NEI significantly increased the odds of reporting to each source. Participants were largely unsatisfied with response from websites and police. Only 42.2% said the website did something helpful and only 29.8% found police helpful. Our findings suggest a need for major improvements in how websites and law enforcement respond to victims of technology-facilitated offenses. They need to have more helpful information and more ways of offering support. Websites need more specifics about the types of violations that warrant reporting, clearer signposts, and encouragement about how to get help and a better publicized commitment to a rapid and serious review. Law enforcement needs more education and training to avoid dismissive and judgmental reactions and to ensure sympathetic and respectful responses.