RESEARCHRacial and Socioeconomic Disparities in Access to Telehealth

Rivera, Veronica; Aldridge, Melissa D.; Ornstein, Katherine; Moody, Kate; Chun, Audrey

doi:10.1111/jgs.16904

Cited by 56 publications

(38 citation statements)

References 6 publications

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“…Studies that were conducted prior to the expansion of telemedicine use in response to the COVID-19 pandemic have reported that younger patients are more likely to use telemedicine, whereas these studies showed mixed results regarding the disparities by area income level and urbanicity of residence. Studies that were conducted after the COVID-19 pandemic found that telemedicine use overall [ 41 , 45 , 46 ] and for geriatric care [ 21 ], primary care [ 19 , 22 , 47 ], or otolaryngological care [ 23 ] was concentrated among younger individuals living in urban high-income areas. Yet, the timeframe used in these studies represented only one early point in the COVID-19 pandemic, and the studies did not focus on the change over time of age and social disparities in telemedicine use.…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted at four clinics in San Francisco reported that the proportion of primary care visits with minority patients aged ≥65 years decreased after telemedicine implementation [19]. Other studies conducted in the United States have found that telemedicine during COVID-19 was concentrated among younger individuals living in urban areas with higher SES [20][21][22][23]. Yet, these findings show disparities only at one point in the COVID-19 pandemic, and evidence is limited as to how disparities in telemedicine use by age and SES changed as the need for telemedicine persisted during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study

Miyawaki¹,

Tabuchi²,

Ong³

et al. 2021

J Med Internet Res

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Background The use of telemedicine outpatient visits has increased dramatically during the COVID-19 pandemic in many countries. Although disparities in access to telemedicine by age and socioeconomic status (SES) have been well-documented, evidence is limited as to how these disparities changed during the COVID-19 pandemic. Moreover, the equity of patient access to telemedicine has been scarcely reported in Japan, despite the huge potential for telemedicine expansion. Objective We aimed to investigate changes due to age and SES disparities in telemedicine use during the COVID-19 pandemic in Japan. Methods Using data from a large internet survey conducted between August 25 and September 30, 2020, in Japan, we examined the associations of participant age and SES (educational attainment, urbanicity of residence, and income level) with their telemedicine use in the following two time periods during the pandemic: April 2020 and August-September 2020. Results Of the 24,526 participants aged 18 to 79 years (50.8% [n=12,446] women), the proportion of individuals who reported using telemedicine increased from 2.0% (n=497) in April 2020 to 4.7% (n=1159) in August-September 2020. After adjusting for potential confounders, younger individuals were more likely to use telemedicine than older individuals in April 2020. Although this pattern persisted in August-September 2020, we also observed a substantial increase in telemedicine use among individuals aged 70 to 79 years (adjusted rates, 0.2% in April 2020 vs 3.8% in August-September 2020; P<.001 after multiple comparisons). We found disparities in telemedicine use by SES in August-September 2020 that did not exist in April 2020. In August-September 2020, individuals with a university degree were more likely to use telemedicine than those with a high school diploma or less (adjusted rates, 6.6% vs 3.5%; P<.001). Individuals living in urban areas exhibited higher rates of telemedicine use than those living in rural areas only in August-September 2020 (adjusted rates, 5.2% vs 3.8%; P<.001). Disparities in telemedicine use by income level were not observed in either time period. Conclusions In general, younger individuals increased their use of telemedicine compared to older individuals during the pandemic, although individuals in their 70s also increased their use of telemedicine. Disparities in telemedicine use by educational attainment and urbanicity of residence widened during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study

Miyawaki¹,

Tabuchi²,

Ong³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Telehealth can be used for improving education, prompting medication adherence, monitoring of vitals, and the application of direct treatments [ 11 ]. Yet, patients from racial and ethnic minority groups face barriers in accessing telehealth [ 12 , 13 ]. Black and Hispanic patients are consistently less likely to have access to the Internet which is necessary for various modes of telehealth [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Telehealth Interventions to Improve Diabetes Management Among Black and Hispanic Patients: a Systematic Review and Meta-Analysis

Anderson

O’Connell

Thomas

et al. 2022

J. Racial and Ethnic Health Disparities

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Background Previous systematic reviews have found that telehealth is an effective strategy for implementing interventions to improve glycemic control and other clinical outcomes for diabetes patients. However, these reviews have not meaningfully focused on Black and Hispanic patients—partly because of the lack of adequate representation of people from racial and ethnic minority groups in clinical trials. It is unclear whether telehealth interventions are effective at improving glycemic control among Black and Hispanic patients given the disproportionate number of barriers they face accessing health care. Objectives A systematic review and meta-analysis of randomized control trials that used telehealth interventions for improving glycemic control among Black and Hispanic diabetes patients. Methods We reviewed PubMed, Embase, Web of Science, CINAHL, PsycINFO, and clinicalTrials.gov from inception to March 2021. We used a narrative summary approach to describe key study characteristics and graded the quality of studies using two reviewers. The pooled net change in HbA1c values was estimated across studies using a random-effects model. Results We identified 10 studies that met our inclusion and exclusion criteria. Nine studies were included in the meta-analysis. Only one study was rated as having low bias. Telehealth interventions were primarily delivered by telephone calls, text messages, web-based portals, and virtual visits. Most interventions involved delivering diabetes self-management education. Telehealth intervention pooled across studies with a mix of Black and Hispanic participants (> 50% sample) was associated with a − 0.465 ([CI: − 0.648 to − 0.282], p = 0.000) reduction in HbA1c. Conclusions Our findings suggest telehealth interventions are effective at improving glycemic control among Black and Hispanic diabetes patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01174-6.

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“…White patients made up a higher proportion of those being seen by telemedicine whereas Native Hawaiian patients tended to be seen in person. The finding of racial disparity in telemedicine access is aligned with that seen in other areas of medicine such as hypertension and diabetes care [12] , geriatrics care [13] , and care of patients with liver disease [14] . To our knowledge, this is the first study to examine telemedicine use in Native Hawaiians with seizures and epilepsy.…”

Section: Discussionmentioning

confidence: 61%

Demographic and technological factors influencing virtual seizure clinic visit satisfaction before and during the Covid-19 pandemic in rural Hawaii

Wong

Williams

Akiona

et al. 2021

Epilepsy & Behavior

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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RESEARCHRacial and Socioeconomic Disparities in Access to Telehealth

Cited by 56 publications

References 6 publications

Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study

Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study

Telehealth Interventions to Improve Diabetes Management Among Black and Hispanic Patients: a Systematic Review and Meta-Analysis

Demographic and technological factors influencing virtual seizure clinic visit satisfaction before and during the Covid-19 pandemic in rural Hawaii

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