Accessibility and Utilization of Telehealth Services During the COVID-19 Pandemic Among Medicare Beneficiaries by Diabetes Status.

Due to the influence types of telehealth services (i.e., phone and/or video) can have on patient care and outcomes, we sought to examine factors associated with the types of telehealth services offered and used among Medicare beneficiaries. We analyzed the Medicare Current Beneficiary Survey COVID-19 Public Use File (N = 1,403 and N = 2,218 for individuals with and without diabetes, respectively) and performed multinomial logit models to examine factors (e.g., sociodemographics, comorbidities, digital access/knowledge) associated with types of telehealth services offered and used among beneficiaries aged ≥65 years by diabetes status. Medicare beneficiaries seemed to prefer using telehealth via phone than video. Regardless of diabetes status, having not previously participated in video or voice calls or conferencing can be a barrier to telehealth being offered and used via video for beneficiaries. For older adults with diabetes, disparities in accessibility of telehealth via video by income and languages spoken other than English were observed. [Research in Gerontological Nursing, 16(3), 134-146.].

Factors Associated with Mental Health of Medicare Beneficiaries During the COVID-19 Pandemic.

OBJECTIVES: This study examined factors associated with the mental health of Medicare beneficiaries during the COVID-19 pandemic. METHODS: The Medicare Current Beneficiary Survey COVID-19 Supplement administered in the Fall of 2020 of beneficiaries aged ≥65 years was analyzed (n = 6,173). A survey-weighted logistic model, adjusted for socio-demographics and comorbidities, was performed to examine factors (e.g., accessibility of medical/daily needs, financial security, and social connectivity) associated with stress/anxiety. RESULTS: Of Medicare beneficiaries, 40.8% reported feeling more stressed/anxious during the pandemic. Factors that were associated with this increased stress/anxiety include the inability to get home supplies (95% CI [3.4%, 16.5%]) or a doctor's appointment (95% CI [1.7%, 20.7%]), feeling less financially secure (95% CI [23.1%, 33.2%]) or socially connected (95% CI [19.1%, 25.6%]), and being female (95% CI [7.2%, 12.2%]), when compared with their respective counterparts. Non-Hispanic blacks were less likely to report feeling more stressed/anxious than non-Hispanic whites (95% CI [-19.9%, -9.0%]). CONCLUSIONS: Our findings highlight that beneficiaries' mental health was adversely influenced by the pandemic, particularly in those who felt financially insecure and socially disconnected. CLINICAL IMPLICATIONS: It is warranted to screen at risk beneficiaries for stress/anxiety during Medicare wellness visits and advocate for programs to reduce those risk factors.