Does Telemedicine Reduce health disparities? Longitudinal Evidence during the COVID-19 Pandemic in the US

Abstract

Objective: The COVID-19 pandemic could be a significant health issue for the elderly population and those with pre-excising chronic condition. In response to the pandemic health care services have increased the use of telehealth medicine. The propose of this study is to examine factors associated with access to telemedicine before and after COVID-19 based on sociodemographic factors and type of chronic disease. Method: We have used data from the Research and Development Survey (RANDS) at two different time points Data collection for the first wave occurred between June 9, 2020 and July 6, 2020 (n= 6786), second wave was between August 3, 2020 and August 20, 2020 (n=5972). Three questions have been asked from the participant: 1) did the provider offer telemedicine before the pandemic? 2) does the provider offer telemedicine during the pandemic? And 3) have the participants schedule telemedicine appointments? Result: In both waves, 62 % of the participants reported providers did not have telemedicine services prior to the COVID-19 pandemic. However, we found a 22% increase in offering telemedicine in six first month of the COVID-19 pandemic. The finding shows almost no change in providing telemedicine between June and August. The data indicates just a 0.5% and 0.1% increase in accessing telemedicine, and scheduling in August than June, respectively. Patients older than 65 had higher access to telemedicine and had higher scheduling frequencies than other age groups, while they had the lowest access prior to the COVID-19. Blacks had the highest access to telemedicine services than other races (40%). Additionally, females, higher education, and living in metropolitan areas were associated with higher access and scheduling during the pandemic. There was a variation of access and scheduling in different chronic diseases, however, providers offered more remote services for those who diagnosed by diabetes. Conclusion: The aim of telemedicine is to reduce disparities in healthcare access. The findings of this study show telemedicine has reduced racial disparities and provided greater accessibility for older groups. However, spatial and educational disparities are still noticeable. Research is necessary to examine how healthcare must address the socioeconomic heterogeneity in telemedicine by avoiding further disparities. Key terms: COVID-19, Telemedicine, health disparities, chronic condition, access to care

Perceptions about Telemedicine among Populations with Chronic Diseases amid COVID-19: Data from a Cross-Sectional Survey

“…In our logistic regression analysis, we found that people with no education and less than 10 years of education were significantly more WRTCCD compared to the people with more than 10 years of education. Similar findings were found in the United States, where those with lower levels of education accessed telemedicine at a higher rate as the pandemic progressed [ 17 ]. This trend might be due to patients with a higher level of education being more concerned about the privacy issues involved with telemedicine.…”

Exploring Quality Differences in Telemedicine Between Hospital Outpatient Departments and Community Clinics: Cross-sectional Study

“…Therefore, it is intuitive to introduce a telemedicine curriculum in medical schools and propose a model of education to effectively leverage telemedicine technologies and artificial intelligence in patient management [ 57 , 58 ]. Mainstreaming telemedicine and video applications in health systems could reduce health care disparities [ 59 ]. The surge in developing telemedicine applications with video call features is one of the most defining trends in this decade and will have a profound impact on socioeconomic and geopolitical realities, in particular in low- and middle-income countries (LMIC) [ 60 , 61 ].…”

Telemedicine and health disparities: Association between patient characteristics and telemedicine, in-person, telephone and message-based care during the COVID-19 pandemic

“…The inequality of socioecomic status may exacerbate health care disparities. The disparities also exist in many clinical fields [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , departments, and countries, but no evidence shows the disparity in the oncology department currently. In this study, we demonstrated patient's forms of care adoption is associated with socioeconomic characteristics during the transition.…”