Sociodemographic Determinants of Missed Telehealth Appointments in Colorectal Surgery

ABSTRACT

INTRODUCTION: The COVID-19 pandemic facilitated telehealth adoption. Multiple barriers may impact accessibility to such services. We estimated the association between sociodemographic and clinical factors, with keeping telehealth appointments. METHOD(S) Single-center retrospective cohort study comprising consecutive telehealth appointments at the Division of Colorectal Surgery (March-December 2020). Demographics, appointment type, diagnosis, and distance to the hospital were collected. Federal Financial Institutions Examination Council's (FFIEC) website was used to obtain estimated family income and poverty levels based on home location. Multivariable clustered logistic regression estimated the association between sociodemographic characteristics and keeping telehealth appointments. RESULT(S) A total of 925 telehealth appointments were analyzed, of which 84.11% were kept. Non-White patients (odds ratio [OR] 0.59, 95% CI 0.39-0.90, p = 0.015), and those with follow-up appointments (OR 0.50, 95% CI 0.31-3.07, p = 0.006) had lower odds of keeping appointments when compared with White patients, and those having postoperative appointments, respectively. Patients who had attended college had higher odds of keeping appointments (OR 1.77, 95% CI 1.02-3.07, p = 0.044) when compared with those who declined to provide their education level (Figure 1). Age, sex, diagnosis, income level, and percentage of people living under poverty within census tracts per FFIEC were not predictors of keeping telehealth appointments. CONCLUSION(S) Patients self-identifying as non-White and presenting for non-postoperative follow-up visits were more likely to miss telehealth appointments. College education was associated with keeping appointments. Future studies could characterize barriers to telehealth programs implementation to optimize access among groups at high risk of non-compliance. (Figure Presented).