Disparities in Telemedicine Utilization for Urology Patients During the COVID-19 Pandemic.

Journal Article (Review;Journal Article)

Objective

To determine the odds of accessing telemedicine either by phone or by video during the COVID-19 pandemic.

Methods

We performed a retrospective study of patients who were seen at a single academic institution for a urologic condition between March 15, 2020 and September 30, 2020. The primary outcome was to determine characteristics associated with participating in a telemedicine appointment (video or telephone) using logistic regression multivariable analysis. We used a backward model selection and variables that were least significant were removed. We adjusted for reason for visit, patient characteristics such as age, sex, ethnicity, race, reason for visit, preferred language, and insurance. Variables that were not significant that were removed from our final model included median income estimated by zip code, clinic location, provider age, provider sex, and provider training.

Results

We reviewed 4234 visits: 1567 (37%) were telemedicine in the form of video 1402 (33.1%) or telephone 164 (3.8%). The cohort consisted of 2516 patients, Non-Hispanic White (n = 1789, 71.1%) and Hispanic (n = 417, 16.6%). We performed multivariable logistic regression analysis and demonstrated that patients who were Hispanic, older, or had Medicaid insurance were significantly less likely to access telemedicine during the pandemic. We did not identify differences in telemedicine utilization when stratifying providers by their age, sex, or training type (physician or advanced practice provider).

Conclusion

We conclude that there are differences in the use of telemedicine and that this difference may compound existing disparities in care. Additionally, we identified that these differences were not associated with provider attributes. Further study is needed to overcome barriers in access to telemedicine.

Full Text

Duke Authors

Cited Authors

  • Javier-DesLoges, J; Meagher, M; Soliman, S; Yuan, J; Hakimi, K; Ghali, F; Nalawade, V; Patel, DN; Monga, M; Murphy, JD; Derweesh, I

Published Date

  • May 2022

Published In

Volume / Issue

  • 163 /

Start / End Page

  • 76 - 80

PubMed ID

  • 34979219

Pubmed Central ID

  • PMC8719918

Electronic International Standard Serial Number (EISSN)

  • 1527-9995

International Standard Serial Number (ISSN)

  • 0090-4295

Digital Object Identifier (DOI)

  • 10.1016/j.urology.2021.11.037

Language

  • eng