Patient Characteristics and Telemedicine Use in the US, 2022

Abstract

ImportanceTelemedicine use was common during the COVID-19 pandemic, expanding many patients’ approaches to accessing health care. Of concern is whether telemedicine access was poorer among higher-needs and disadvantaged populations.ObjectiveTo assess patient characteristics associated with telemedicine use and telemedicine mode and describe telemedicine visit experiences by telemedicine mode.Design, Setting, and ParticipantsThis cross-sectional study included data from the 2022 Health Information National Trends Survey and included US adults with a health care visit. Data were analyzed from May to September 2023.ExposurePatient characteristics.Main Outcomes and MeasuresAny telemedicine visits vs in-person visits only; telemedicine mode (video vs audio-only). Multivariable logistic models assessed patient characteristics associated with telemedicine visits and mode. Bivariate analyses compared telemedicine experiences by mode.ResultsThe study included 5437 adult patients (mean [SE] age, 49.4 [0.23] years; 3136 females [53.4%]; 1928 males [46.6%]). In 2022, 2384 patients (43%) had a telemedicine visit; 1565 (70%) had a video visit while 819 (30%) had an audio-only visit. In multivariable models, older age (≥75 years: adjusted odds ratio [aOR], 0.63; 95% CI, 0.42-0.94), no internet use (aOR, 0.62; 95% CI, 0.48-0.81), and living in the Midwest (aOR, 0.50; 95% CI, 0.35-0.70) were negatively associated with having telemedicine visits. Female sex (aOR, 1.43; 95% CI, 1.12-1.83), having chronic conditions (aOR, 2.13; 95% CI, 1.66-2.73), and multiple health care visits (2-4 visits: aOR, 1.77; 95% CI, 1.23-2.54; ≥5 visits: aOR, 3.29; 95% CI, 2.20-4.92) were positively associated. Among individuals who used telemedicine, older age (65-74 years: aOR, 2.13; 95% CI, 1.09-4.14; ≥75 years: aOR, 3.58; 95% CI, 1.60-8.00), no health insurance (aOR, 2.84; 95% CI, 1.42-5.67), and no internet use (aOR, 2.11; 95% CI, 1.18-3.78) were positively associated with having audio-only visits. We observed no significant differences in telemedicine use or mode by education, race and ethnicity, or income. Patients’ experiences using telemedicine were generally similar for video and audio-only except more individuals who used audio-only had privacy concerns (20% vs 12%, P = .02).Conclusions and RelevanceIn this cross-sectional study of adults with health care visits, many patients, including those with the greatest care needs, chose telemedicine even after in-person visits were available. These findings support continuing this care delivery approach as an option valued by patients. Differences were not observed by most common measures of socioeconomic status. Continued monitoring of telemedicine use is needed to ensure equitable access to health care innovations.

Disparities in Status, Patterns, and Preferences of Internet Medical Services Utilization for Patients During the Post-COVID-19 Pandemic Period in China: Evidence from Provincial Field and National Online Surveys

“…The prevalence of IMSU (39.43% with the provincial eld survey data) reported in our results was similar to the latest data reported in Health Information National Trends Survey (HINTS) in the U.S. (39.3%), and were consistent with prior literature on digital health inequities among patients with inferior demographic (e.g., gerontal patients) and socio-economic factors (e.g., educated at basic education level), as well as increased IMSU accessed among patients with poorer health status (e.g., suffering multi chronic diseases) , but not for gender in this study [13,20,25,[27][28][29][30]. We also found that, the respondents from the national online survey with superior demographic and socio-economic factors, but poorer health status than those from the provincial eld survey.…”

“…Our results showed that, Chinese patients were mostly limited to shallow IMS (e.g., minor disease, and routine visit) mainly provided by private platform and Internet hospital, regardless of the data from the provincial eld survey or the national online survey. However, the respondents with superior demographic (e.g., aged below 60 years old) and socio-economic factors (e.g., higher annual disposable income) from the national online survey were more likely to be deeply involved in IMSU (e.g., mental diseases: 374 times with 10.44%; telediagnosis: 378 times with 8.23%), which were consistent with previous studies [30][31][32][33][34]. Prior research has also indicated that the patterns of IMSU would be deepen in the patients with a chronic condition, nevertheless, in this study, patients suffering chronic diseases were less accessed to IMSU that those not suffering (35.59% vs. 40.56%) based on the provincial eld survey data, and patients suffering chronic diseases accessed to IMSU at a high frequency was lower than that at a low frequency (29.86% vs. 34.45%) based on the national online survey data [13,20,32,[35][36][37][38][39].…”

Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study

“…Then, urgent needs during the first year of the COVID-19 pandemic created a surge of adoption and reduction in regulatory barriers to telemedicine [54][55][56]. Now that we are past the crisis period, health systems, providers, and patients are exploring how, when, and where to use telemedicine in service of multistakeholder outcomes [57,58]. Despite its widespread adoption, research acknowledges limitations in today's most prevalent telemedicine systems, which rely primarily on synchronous, interactive video sessions and chat capabilities [59].…”