- A new study shows that patients from disadvantaged communities were less likely to have access to telemedicine during the pandemic
- Massachusetts Eye Clinic ophthalmologists analyze their patient demographics in 2020
- They found that black patients, non-English speakers, and those who did not attend college were less likely to receive care via telemedicine.
- In addition, older, less educated and unemployed were more likely to seek telephone-based visits rather than video calls.
- Researchers say findings suggest that implementing telemedical care does not improve access to care for all Americans
A new study shows that patients from disadvantaged communities were less likely to have access to telemedicine during the pandemic.
Ophthalmologists at the Massachusetts Eye and Ear Clinic in Boston analyzed patient demographics in 2020, finding that black patients, non-English speakers and those not attending college, were less likely to seek care via telemedicine.
In addition, patients who were older, less educated, unemployed, retired, or disabled were more likely to seek telephone-based visits rather than video-based visits.
“The implementation of telemedical care does not improve access to care for all populations, and excessive reliance on telemedicine using current approaches may inadvertently increase health disparities,” the team said.
A new study shows that black patients and people from other disadvantaged communities were less likely to use telemedicine during a pandemic
Telemedicine visits increased in May 2020, then declined as clinic reopened in summer
Telemedicine has become popular during the pandemic as a way for doctors to see patients without putting them at risk of COVID-19.
In a telemedicine visit, a patient talks to their doctor via video or phone call instead of visiting the doctor’s office in person.
The practice was particularly used in spring 2020, when several state and local leaders ordered stay-at-home orders and health clinics canceled non-essential medical services.
But access to telemedicine was easier for some patients than others.
Low-income, minority, and other disadvantaged populations may be less likely to have a smartphone, computer, Wi-Fi, or technical knowledge to attend a telemedicine appointment.
A new study by ophthalmologists provides additional evidence for this trend.
the study – Published Thursday in JAMA Ophthalmology It also includes contributions from ophthalmologists from Johns Hopkins, Harvard and New York University.
Ophthalmologists analyzed all patient appointments at a Massachusetts clinic between January 1 and December 31, 2020.
Since the state went into lockdown in spring 2020, the policy of the clinic was to use video visits whenever possible and to talk to patients on the phone when video was not available.
Overall, the clinic saw approximately 2,300 telemedicine visits in 2020, involving 1,900 patients.
The researchers found that the demographics of telemedicine patients reflect disparities in access to this service.
For example: Black patients were 0.69 times as likely to visit telemedicine than white patients.
Non-English speakers were 0.63 times as likely to visit telemedicine as those who spoke English as their first language.
Patients who did not attend college were 0.83 times more likely to have a telemedicine appointment than those who had a postgraduate education.
And men were less likely than women to make telemedicine appointments – 0.86 times as likely.
The researchers found that older patients were more likely to make telemedicine appointments over the phone, not the computer, than younger patients.
Researchers also found that older patients were less likely to receive telemedicine care.
The median age of telemedicine patients was 61, while the mean age of those patients who received in-person care was 63.
If an older patient had a telemedicine appointment, they were more likely to do it over the phone, the analysis showed.
Patients who did not attend college were more likely to have telemedicine visits over the phone – than over video – as well as those who were retired, unemployed and disabled.
Most telemedicine patients had previously received care in the clinic – only 22.3 percent of patients were new to the clinic.
Established patients were more likely to be older adults, suggesting that older patients may be less likely to seek a new doctor or new diagnosis via telemedicine.
Telemedicine was most popular in spring 2020, aligning with stay-at-home policies in Massachusetts.
The clinic saw the highest number of telemedicine visits in May: 181 visits in the week of May 10.
In early June, the clinic announced its reopening plan – leading to a decline in telemedicine visits, followed by a plateau in late August.
Some patients opted to continue using telemedicine until the end of 2020.
This study aligns with other research showing that telemedicine can make access to healthcare difficult for already disadvantaged populations.
The researchers wrote, “Our findings highlight the fact that the implementation of telemedical care does not improve access to care for all populations, and that excessive reliance on telemedicine using current approaches may inadvertently affect historically marginalized populations.” could exacerbate health inequalities.”
Other studies suggest that black patients, low-income patients, and those living in rural areas are less likely to use telemedicine.
Barriers to these patients may include lack of internet or access to electronic devices, as well as low technology and health literacy, the researchers said.
This trend can also be seen in the preference for phones over video visits of disadvantaged patients – as phone visits are easier to attend and do not require the Internet.
This study was retrospective — looking at patients’ medical records — and focused on a clinic in Massachusetts.
Clinics in other…