Not all population groups have experienced equal access to telehealth during the pandemic, according to a new study.
Older adults and Black and Hispanic patients are less likely to utilize telehealth than their white and Asian peers during the early days of the COVID-19 pandemic, according to research published in the Journal of the American Medical Informatics Association.
“While telehealth has many benefits, especially during a global pandemic, it may create and/or exacerbate health disparities,” the researchers told PatientEngagementHIT.
Using data on 40,000 patient encounters at Mount Sinai Hospital in New York City between March 20 and May 28, researchers found stark differences in how certain populations used telehealth, emergency departments (ED), and in-clinic care to address COVID-19 symptoms.
The study’s patient population consisted of people who were white (32%), Black (19%), Hispanic (19%), and Asian (6%), and those who identified as “other/unknown” (24%).
Among the study’s major findings:
- Telehealth use: White and Asian patients, and those in the “other/unknown” category, were more likely to use telehealth than their Black and Hispanic peers.
- ED use: Two thirds (60%) of Black patients and 48% of Hispanic patients used the ED instead of telehealth. Black patients were 4.3-times more likely to use the ED and 1.4-times more likely to use clinic care than their white peers during the height of the pandemic. Hispanic patients were 2.5-times more likely to access the ED and 1.2-times more likely to access clinic care than white patients.
- Age differences: Only 24% of adults over age 65 used telehealth, compared with 41% of patients aged 18 to 29 and 47% of patients aged 30 to 49.
- Language differences: Only about a quarter of Spanish-speaking patients chose to use telehealth over the ED. Among patients preferring another language besides English or Spanish, a similar proportion used telehealth over the ED.
Researchers suggest that the social determinants of health could fuel these health disparities. Healthcare self-efficacy, access to technology, and a strong Wi-Fi or broadband signal—all necessary for telehealth—are more likely to be out-of-reach for individuals facing challenges related to the social determinants of health, they said.
Read the PatientEngagementHIT summary or the full journal article.