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Demographic Disparity in Use of Telemedicine for Ambulatory General Surgical Consultation During the COVID-19 Pandemic: Analysis of the Initial Public Health Emergency and Second Phase Periods.
Eruchalu, Chukwuma N; Bergmark, Regan W; Smink, Douglas S; Tavakkoli, Ali; Nguyen, Louis L; Bates, David W; Cooper, Zara; Ortega, Gezzer.
  • Eruchalu CN; From the Harvard Medical School, Boston, MA (Eruchalu).
  • Bergmark RW; Center for Surgery and Public Health, Department of Surgery (Eruchalu, Bergmark, Smink, Nguyen, Cooper, Ortega), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Smink DS; Center for Surgery and Public Health, Department of Surgery (Eruchalu, Bergmark, Smink, Nguyen, Cooper, Ortega), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Tavakkoli A; Center for Surgery and Public Health, Department of Surgery (Eruchalu, Bergmark, Smink, Nguyen, Cooper, Ortega), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Nguyen LL; Division of General and Gastrointestinal Surgery, Department of Surgery (Smink, Tavakkoli), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Bates DW; Division of General and Gastrointestinal Surgery, Department of Surgery (Smink, Tavakkoli), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Cooper Z; Laboratory for Surgical and Metabolic Research (Tavakkoli), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Ortega G; Center for Surgery and Public Health, Department of Surgery (Eruchalu, Bergmark, Smink, Nguyen, Cooper, Ortega), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Am Coll Surg ; 234(2): 191-202, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1713819
ABSTRACT

BACKGROUND:

Surgical patients with limited digital literacy may experience reduced telemedicine access. We investigated racial/ethnic and socioeconomic disparities in telemedicine compared with in-person surgical consultation during the coronavirus disease 2019 (COVID-19) pandemic. STUDY

DESIGN:

Retrospective analysis of new visits within the Division of General & Gastrointestinal Surgery at an academic medical center occurring between March 24 through June 23, 2020 (Phase I, Massachusetts Public Health Emergency) and June 24 through December 31, 2020 (Phase II, relaxation of restrictions on healthcare operations) was performed. Visit modality (telemedicine/phone vs in-person) and demographic data were extracted. Bivariate analysis and multivariable logistic regression were performed to evaluate associations between patient characteristics and visit modality.

RESULTS:

During Phase I, 347 in-person and 638 virtual visits were completed. Multivariable modeling demonstrated no significant differences in virtual compared with in-person visit use across racial/ethnic or insurance groups. Among patients using virtual visits, Latinx patients were less likely to have video compared with audio-only visits than White patients (OR, 0.46; 95% CI 0.22-0.96). Black race and insurance type were not significant predictors of video use. During Phase II, 2,922 in-person and 1,001 virtual visits were completed. Multivariable modeling demonstrated that Black patients (OR, 1.52; 95% CI 1.12-2.06) were more likely to have virtual visits than White patients. No significant differences were observed across insurance types. Among patients using virtual visits, race/ethnicity and insurance type were not significant predictors of video use.

CONCLUSION:

Black patients used telemedicine platforms more often than White patients during the second phase of the COVID-19 pandemic. Virtual consultation may help increase access to surgical care among traditionally under-resourced populations.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Office Visits / General Surgery / Telemedicine / Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Am Coll Surg Journal subject: Gynecology / Obstetrics Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Office Visits / General Surgery / Telemedicine / Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Am Coll Surg Journal subject: Gynecology / Obstetrics Year: 2022 Document Type: Article