Use of a telehealth device for primary care varies by age, ethnicity, and income

Current Repetitive Uses of telehealth It may differ among American patients by age, race and income, according to the new findings.

A cross-sectional analysis of telehealth use among American adults in the Penn Medicine health care system suggested that tablets and phones were the most commonly used tools for tele-care visits and consultations—although the rate of use differed between younger and older patients as well as those of different ethnicities. And different races.

The new data could point to a future frontline telehealth strategy, as well as efforts at the public health level to expand the availability of telehealth across various US residents.

A team led by Alison Hare, MD, and Eric Pressman, MD, MSHP, of the Perelman School of Medicine’s Department of Medicine, conducted a study of telehealth visits conducted at a Penn Medicine primary care practice during the COVID-19 pandemic. The team sought to explain the variance of devices used by patients based on demographics, noting that previous research lacked such context despite the increasing focus on the practice of remote care.

“Given the increase in the use of telehealth during the COVID-19 pandemic, there are concerns about unequal access to telehealth among underserved populations,” they wrote. “Efforts to improve access to telehealth can be facilitated by a better understanding of how patients access these visits.”

The team identified adults under 18 years of age who completed their first telehealth visit between December 9, 2020 and September 30, 2021 in their primary care practice. They assessed each patient’s self-reported race and ethnicity, as well as ZIP code-based household income data based on electronic health records.

A multivariate logistic regression model using generalized estimation equations helped analyze the association between patient demographics and the use of telehealth tools such as phones, tablets, computers or laptops. Hare and Pressman also reported odds ratios (ORs) for comparing use of each device based on patient demographics.

The final analysis included 55,812 adult patients who completed 1 telehealth visit in the clinic. Among them, 41.6% (n = 23243) used a desktop computer or laptop to visit them, while 58.4% (n = 32569) used a phone or tablet.

White patients were significantly less likely than black patients to use a phone or tablet during their visit (OR, 0.44; 95% CI, 0.36–0.52) as were non-Hispanic and non-Hispanic patients versus Hispanic or Hispanic patients (OR, 0.73; 95% CI, 0.66 – 0.81).

The investigators also observed lower phone or tablet use among adults aged over 80 versus those aged 18–29 (OR, 0.79; 95% CI, 0.68–0.91) as well as among those with greater median income per ZIP code, versus lower average income (OR, 0.79; 95% CI, 0.70–0.90).

Hare, Pressman, and their colleagues emphasize that these observed disparities in telehealth may inform and tailor strategies around enhancing the availability of telehealth in the United States.

“Desktop or laptop use depends on wired broadband access, while smartphones and many tablets can use wired or wireless broadband,” they wrote. “Our findings suggest that other than the recent significant federal investment in wired broadband, other opportunities (for example, financial support for cellular data plans, expansion of 5G networks in underserved communities) may help support patients in accessing healthcare services from afar.”

They called for future interventions that might “close the digital divide,” such as further analysis of the type of telehealth device a patient is using.

the study, “Correlation between patient demographics and devices used to access telehealth visits in a US primary care network‘online at Gamma Health Forum.

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