Patient-related barriers to some virtual healthcare services among cancer patients in the USA: a population-based study.

Objective: To assess the patient-related barriers to access of some virtual healthcare tools among cancer patients in the USA in a population-based cohort. Materials & methods: National Health Interview Survey datasets (2011-2018) were reviewed and adult participants (≥18 years old) with a history of cancer diagnosis and complete information about virtual healthcare utilization (defined by [a] filling a prescription on the internet in the past 12 months and/or [b] communicating with a healthcare provider through email in the past 12 months) were included. Information about video-conferenced phone calls and telephone calls are not available in the National Health Interview Survey datasets; and thus, they were not examined in this study. Multivariable logistic regression analysis was used to evaluate factors associated with the utilization of virtual care tools.
Results: A total of 25,121 participants were included in the current analysis; including 4499 participants (17.9%) who utilized virtual care in the past 12 months and 20,622 participants (82.1%) who did not utilize virtual care in the past 12 months. The following factors were associated with less utilization of virtual healthcare tools in multivariable logistic regression: older age (continuous odds ratio [OR] with increasing age: 0.987; 95% CI: 0.984-0.990), African-American race (OR for African American vs white race: 0.608; 95% CI: 0.517-0.715), unmarried status (OR for unmarried compared with married status: 0.689; 95% CI: 0.642-0.739), lower level of education (OR for education ≤high school vs >high school: 0.284; 95% CI: 0.259-0.311), weaker English proficiency (OR for no proficiency vs very good proficiency: 0.224; 95% CI: 0.091-0.552) and lower yearly earnings (OR for earnings <$45,000 vs earnings >$45,000: 0.582; 95% CI: 0.523-0.647).
Conclusion: Older patients, those with African-American race, lower education, lower earnings and weak English proficiency are less likely to access the above studied virtual healthcare tools. Further efforts are needed to tackle disparities in telemedicine access.