Since early on in the COVID-19 pandemic, telemedicine has seen major growth. But not all populations have taken advantage of the opportunity to maintain care, especially ethnic/racial minorities and older patients.
In a recent study, researchers aimed to identify the socioeconomic and demographic disparities, specifically in telemedicine for ophthalmic care. Over 8,000 completed clinical encounters for 5,023 patients during the first six months of the pandemic were included.
Of these patients, 8.9% participated in a video encounter, 12.8% completed a telephone appointment and 78.3% attended clinical appointments in-person only. In adjusted analysis, patients who were Black/African-American or Hispanic/Latino were significantly less likely to complete an appointment in a virtual setting by telephone or video. Older patients, patients whose primary language was not English, Black/African-American patients and Hispanic/Latino patients were significantly less likely to complete a video visit. Among patients using any telehealth modalities, older patients and Black/African-Americans were significantly more likely to complete only phone encounters.
The authors suggest elderly patients are more likely to have motor or sensory limitations which impact their access to telemedicine, and lower rates of smartphone ownership and Internet access impact ethnic minorities’ access—as well as wealth disparities among racial groups and financial strains caused by COVID-19.
“Our findings indicate that a technology intended to reduce inequitable healthcare access may unintentionally exacerbate pre-existing disparities in healthcare utilization,” the authors concluded in their study. These lower rates of telemedicine visits are similar to previous documented differences in technology, access and trust, they note.
The authors also suggest in order to expand telemedicine usage across the country and the need to reduce the disparate impact of COVID-19 on minority populations, further research is necessary to identify barriers to telehealth utilization and opportunities to improve access.
Chen EM, Andoh JE, Nwanyanwu K. Socioeconomic and demographic disparities in the utilization of telemedicine for ophthalmic care during the COVID-19 pandemic. Ophthalmology. Epub ahead of print.