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Age and Racial Disparities in Telemedicine Utilization in an Academic Orthopedic Surgery Department.
Annapragada, Akshaya V; Meshram, Prashant; Jenkins, Sabrina G; Jain, Amit; Middleton, Kellie K; Thakkar, Savya C; Levin, Adam S; Srikumaran, Uma.
  • Annapragada AV; The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Meshram P; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
  • Jenkins SG; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
  • Jain A; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
  • Middleton KK; Northside Hospital, Cumming, Georgia, USA.
  • Thakkar SC; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
  • Levin AS; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
  • Srikumaran U; Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Telemed J E Health ; 28(7): 970-975, 2022 07.
Article in English | MEDLINE | ID: covidwho-1493648
ABSTRACT

Introduction:

The COVID-19 pandemic has highlighted significant racial and age-related health disparities. In response to pandemic-related restrictions, orthopedic surgery departments have expanded telemedicine use. We analyzed data from a tertiary care institute during the pandemic to understand potential racial and age-based disparities in access to care and telemedicine utilization. Materials and

Methods:

Data on patient race and age, and numbers of telemedicine visits, in-person office visits, and types of telemedicine were extracted for time periods during and preceding the pandemic. We calculated odds ratios for visit occurrence and type across race and age groups.

Results:

Patients ages 27-54 were 1.3 (95% confidence interval [CI] 1.1-1.4, p < 0.01) and 1.2 (95% CI 1.0-1.3, p < 0.05) times more likely to be seen than patients <27 during the pandemic, versus the 2019 and 2020 controls. Patients 54-82 were 1.3 (95% CI 1.1-1.5, p < 0.001) times more likely to be seen than patients <27 during the pandemic versus the 2019 control. Patients 27-54, 54-82, and 82+, respectively, were 3.3 (95% CI 2.6-4.2, p < 1e-20), 3.5 (95% CI 2.8-4.4, p < 1e-24), and 1.9 (95% CI 1.1-3.4, p < 0.05) times more likely to be seen by telemedicine than patients <27. Among pandemic telemedicine appointments, Black patients were 1.5 (95% CI 1.2-1.9, p < 1e-3) times more likely to be seen by audio-only telemedicine than White patients, as compared with video telemedicine.

Conclusions:

Telemedicine access barriers must be reduced to ensure that disparities during the pandemic do not persist.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / Orthopedic Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans / Middle aged Language: English Journal: Telemed J E Health Journal subject: Medical Informatics / Health Services Year: 2022 Document Type: Article Affiliation country: Tmj.2021.0330

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / Orthopedic Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans / Middle aged Language: English Journal: Telemed J E Health Journal subject: Medical Informatics / Health Services Year: 2022 Document Type: Article Affiliation country: Tmj.2021.0330