Disparities in telemedicine satisfaction among older and nonwhite dermatology patients: A cross-sectional study

ABSTRACT

Background: Telemedicine use has expanded rapidly during the COVID-19 pandemic. There is limited data on patient satisfaction with teledermatology;therefore, we examined patient teledermatology experiences at a large academic center. Methods: After Weill Cornell Medicine Institutional Review Board approval, patients scheduled for teledermatology visits (1/2021-4/2021) were enrolled and sent pre/postconsultation questionnaires about telemedicine satisfaction, expectations, and concerns (5-point Likert scale) (82% response rate). Results: Of 202 participants, 120 (59%) were female with mean age 49 years. Participants were largely White (78%) and non-Hispanic (86%). The majority had at least a college degree (94%) and were employed (66%). Younger patients (21-40) were more satisfied with telemedicine (P =.016), and its convenience (P =.001), compared with older participants (>66) (P =.001, P =.019). Those with shorter travel times (<30 min) preferred in-person visits (P =.031). Nonwhite race was associated with greater concerns for conversation privacy and inappropriate information access (both P =.004). White race was associated with greater confidence in telemedicine diagnosis (P =.032). Participants had less trouble hearing and seeing than anticipated (P ≤.001 and P =.005). Patients were more interested in using telemedicine and preferred it over in-person appointments post- vs. preconsultation (P<.001 both). Conclusion: Our study demonstrates overall positive attitudes towards teledermatology. However, decreased satisfaction and confidence were found amongst older and nonwhite patients. Patients with longer vs. shorter clinic proximity preferred telemedicine to in-person visits, which may improve access to care in areas without dermatologists. Our study clarified specific concerns that may be used to devise strategies to encourage universal utilization of teledermatology where appropriate.