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Appl Clin Inform 2021; 12(04): 836-844
DOI: 10.1055/s-0041-1733848
Research Article

Telemedicine Adoption during the COVID-19 Pandemic: Gaps and Inequalities

Jake Luo
1   Department of Health Informatics and Administration, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
,
Ling Tong
1   Department of Health Informatics and Administration, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States
,
Bradley H. Crotty
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
,
Melek Somai
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
,
Bradley Taylor
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
,
Kristen Osinski
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
,
Ben George
2   Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert and Medical College of Wisconsin Health Network, Milwaukee, Wisconsin, United States
3   Cancer Center, Froedtert Hospital, Milwaukee, Wisconsin, United States
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Abstract

Background The telemedicine industry has been experiencing fast growth in recent years. The outbreak of coronavirus disease 2019 (COVID-19) further accelerated the deployment and utilization of telemedicine services. An analysis of the socioeconomic characteristics of telemedicine users to understand potential socioeconomic gaps and disparities is critical for improving the adoption of telemedicine services among patients.

Objectives This study aims to measure the correlation of socioeconomic determinants with the use of telemedicine services in Milwaukee metropolitan area.

Methods Electronic health record review of patients using telemedicine services compared with those not using telemedicine services within an academic-community health system: patient demographics (e.g., age, gender, race, and ethnicity), insurance status, and socioeconomic determinants obtained through block-level census data in Milwaukee area. The telemedicine users were compared with all other patients using regression analysis. The telemedicine adoption rates were calculated across regional ZIP codes to analyze the geographic patterns of telemedicine adoption.

Results A total of 104,139 patients used telemedicine services during the study period. Patients who used video visits were younger (median age 48.12), more likely to be White (odds ratio [OR] 1.34; 95% confidence interval [CI], 1.31–1.37), and have private insurance (OR 1.43; CI, 1.41–1.46); patients who used telephone visits were older (median age 57.58), more likely to be Black (OR 1.31; CI 1.28–1.35), and have public insurance (OR 1.30; CI 1.27–1.32). In general, Latino and Asian populations were less likely to use telemedicine; women used more telemedicine services in general than men. In the multiple regression analysis of social determinant factors across 126 ZIP codes, college education (coefficient 1.41, p = 0.01) had a strong correlation to video telemedicine adoption rate.

Conclusion Adoption of telemedicine services was significantly impacted by the social determinant factors of health, such as income, education level, race, and insurance type. The study reveals the potential inequities and disparities in telemedicine adoption.

Keywords

telemedicine - telehealth - health services - COVID-19 - health inequality - health system

Protection of Human and Animal Subjects

No human subjects were involved in the project. De-identified patient data was used.


Supplementary Material



Publication History

Received: 16 February 2021

Accepted: 27 June 2021

Article published online:
08 September 2021

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