Erica Jaiyeola Odukoya1, Juan Andino2,3, Sophia Ng2, Emma Steppe2, Chad Ellimoottil2,3. 1. University of Michigan Medical School, Ann Arbor, Michigan. 2. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan. 3. Department of Urology, University of Michigan, Ann Arbor, Michigan.
Abstract
Introduction: During the COVID-19 public health emergency, telehealth use grew due to regulatory and reimbursement surrounding the use of video and audio-only visits for the evaluation and management of patients. Methods: We retrospectively reviewed patients seeking outpatient urological care from April 1, 2020 to June 30, 2020 at a urological tertiary care center. Our study was designed to determine the relative effect of demographic, socioeconomic and geographic variables on the likelihood of using video compared to an audio-only telehealth. Results: We identified 4,744 unique patients who had a urological telehealth visit. Demographic factors associated with lower probability of utilizing video telehealth were older age (ages >65 years, average marginal effect [AME] -38.3, 95% CI -40.8, -34.7), Black/African American race and American Indian and Alaska Native race (AME -9.7, 95% CI -10.7, -7.1; AME -17.1, 95% CI -18.8, -13.7, respectively), interpreter use (AME -4.5, 95% CI -5, -3.1), Medicaid insurance (AME -13.3, 95% CI -14.8, -9.8), rural residence and living in area with low broadband Internet access (AME -12.8, 95% CI -14.1, -9.1). Conclusions: Forty-four percent of patients used audio-only visits to connect with their urologists. Age, ethnicity, rurality, type of insurance and broadband access all impacted the type of telehealth used to receive urological care. Without coverage and reimbursement of audio-only visits, video telehealth could exacerbate health disparities in access to urological care.
Introduction: During the COVID-19 public health emergency, telehealth use grew due to regulatory and reimbursement surrounding the use of video and audio-only visits for the evaluation and management of patients. Methods: We retrospectively reviewed patients seeking outpatient urological care from April 1, 2020 to June 30, 2020 at a urological tertiary care center. Our study was designed to determine the relative effect of demographic, socioeconomic and geographic variables on the likelihood of using video compared to an audio-only telehealth. Results: We identified 4,744 unique patients who had a urological telehealth visit. Demographic factors associated with lower probability of utilizing video telehealth were older age (ages >65 years, average marginal effect [AME] -38.3, 95% CI -40.8, -34.7), Black/African American race and American Indian and Alaska Native race (AME -9.7, 95% CI -10.7, -7.1; AME -17.1, 95% CI -18.8, -13.7, respectively), interpreter use (AME -4.5, 95% CI -5, -3.1), Medicaid insurance (AME -13.3, 95% CI -14.8, -9.8), rural residence and living in area with low broadband Internet access (AME -12.8, 95% CI -14.1, -9.1). Conclusions: Forty-four percent of patients used audio-only visits to connect with their urologists. Age, ethnicity, rurality, type of insurance and broadband access all impacted the type of telehealth used to receive urological care. Without coverage and reimbursement of audio-only visits, video telehealth could exacerbate health disparities in access to urological care.
Authors: Ateev Mehrotra; Haiden A Huskamp; Jeffrey Souza; Lori Uscher-Pines; Sherri Rose; Bruce E Landon; Anupam B Jena; Alisa B Busch Journal: Health Aff (Millwood) Date: 2017-05-01 Impact factor: 6.301
Authors: William J Hall; Mimi V Chapman; Kent M Lee; Yesenia M Merino; Tainayah W Thomas; B Keith Payne; Eugenia Eng; Steven H Day; Tamera Coyne-Beasley Journal: Am J Public Health Date: 2015-10-15 Impact factor: 9.308
Authors: Lauren A Eberly; Sameed Ahmed M Khatana; Ashwin S Nathan; Christopher Snider; Howard M Julien; Mary Elizabeth Deleener; Srinath Adusumalli Journal: Circulation Date: 2020-06-08 Impact factor: 39.918
Authors: Rumi Chunara; Yuan Zhao; Ji Chen; Katharine Lawrence; Paul A Testa; Oded Nov; Devin M Mann Journal: J Am Med Inform Assoc Date: 2021-01-15 Impact factor: 4.497