Bridging Access to Pediatric Pain Care

Abstract

Objectives: To evaluate subsequent shifts to patient access to tertiary pain management care following shelter-in-place (SIP) and increased telehealth during the COVID-19 pandemic. Materials and Methods: Retrospective naturalistic design was used. Data for this study were extracted from a retrospective review of the Pediatric-Collaborative Health Outcomes Information Registry, with additional demographic information collected using chart review. Participants were 906 youth who received an initial evaluation either in-person (n=472) within the 18 months before SIP or through telehealth (n=434) within the 18 months after SIP during the COVID-19 pandemic. Patient variables to assess access included geographic distance from the clinic, ethnic and racial diversity, and patient’s insurance type. Descriptive characteristics for each group were analyzed using χ2 test, percentage change, and t-test analyses. Results: Data indicated that transitioning to telehealth resulted in maintained access rates between groups as measured by race and ethnic diversity as well as distance traveled from the clinic. A trend toward increase in government-funded insurance was found, though no statistically significant differences were identified between telehealth and in-person visits. Though the majority of participants (in-person: 52.75%; telehealth 55.81%) lived within 50 miles of the clinic, results indicated that telehealth allowed for a statistically significant increase in evaluation access for families living further from the clinic within a 50-mile radius. Discussion: Overall, accessibility to pediatric pain management through telehealth during SIP was maintained despite significant declines in overall access to health care, with some trends in increased accessibility for patients with government insurance.