During the COVID-19 pandemic, video-based telemedicine use was significantly lower for patients aged ≥80 years (OR 0.24; 95% CI 0.21-0.28), Black patients, and those on Medicaid.
Observational (n=113,888)
Yes
Are there sociodemographic disparities in the use of telemedicine for cardiovascular ambulatory care during the COVID-19 pandemic?
Significant sociodemographic disparities exist in the use of video-based telemedicine for cardiovascular care, disproportionately affecting older, Black, non-English speaking, and Medicaid-insured patients.
Odds Ratio: 0.24 (95% CI 0.21–0.28)
BACKGROUND: The COVID-19 pandemic accelerated adoption of telemedicine in cardiology clinics. Early in the pandemic, there were sociodemographic disparities in telemedicine use. It is unknown if these disparities persisted and whether they were associated with changes in the population of patients accessing care. METHODS: We examined all adult cardiology visits at an academic and an affiliated community practice in Northern California from March 2019 to February 2020 (pre-COVID) and March 2020 to February 2021 (COVID). We compared patient sociodemographic characteristics between these periods. We used logistic regression to assess the association of patient/visit characteristics with visit modality (in-person vs telemedicine and video- vs phone-based telemedicine) during the COVID period. RESULTS: There were 54,948 pre-COVID and 58,940 COVID visits. Telemedicine use increased from <1% to 70.7% of visits (49.7% video, 21.0% phone) during the COVID period. Patient sociodemographic characteristics were similar during both periods. In adjusted analyses, visits for patients from some sociodemographic groups were less likely to be delivered by telemedicine, and when delivered by telemedicine, were less likely to be delivered by video versus phone. The observed disparities in the use of video-based telemedicine were greatest for patients aged ≥80 years (vs age <60, OR 0.24, 95% CI 0.21, 0.28), Black patients (vs non-Hispanic White, OR 0.64, 95% CI 0.56, 0.74), patients with limited English proficiency (vs English proficient, OR 0.52, 95% CI 0.46-0.59), and those on Medicaid (vs privately insured, OR 0.47, 95% CI 0.41-0.54). CONCLUSIONS: During the first year of the pandemic, the sociodemographic characteristics of patients receiving cardiovascular care remained stable, but the modality of care diverged across groups. There were differences in the use of telemedicine vs in-person care and most notably in the use of video- vs phone-based telemedicine. Future studies should examine barriers and outcomes in digital healthcare access across diverse patient groups.
Osmanlliu et al. (Sun,) conducted a observational in Cardiovascular disease (n=113,888). Sociodemographic factors (e.g., age ≥80 years) vs. Reference sociodemographic groups (e.g., age <60 years) was evaluated on Use of video-based versus phone-based telemedicine (OR 0.24, 95% CI 0.21-0.28). During the COVID-19 pandemic, video-based telemedicine use was significantly lower for patients aged ≥80 years (OR 0.24; 95% CI 0.21-0.28), Black patients, and those on Medicaid.