Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic.
Eur Heart J Digit Health
; 2(2): 244-253, 2021 Jun.
Article
in English
| MEDLINE | ID: covidwho-2313247
ABSTRACT
Aims:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods andresults:
In this single-centre retrospective study, all ambulatory cardiovascular encounters occurring between 16 March and 19 June 2020 were assessed. Baseline characteristics by visit type (in-person, TM phone, TM video) were compared using Chi-square and student t-tests, with statistical significance defined by P-value <0.05. Multivariate logistic regression was used to explore the predictors of TM vs. in-person care. A total of 8446 patients [86% Non-Hispanic (NH) White, 42% female, median age 66.8 ± 15.2 years] completed an ambulatory cardiovascular visit during the study period. TM phone (n = 4981, 61.5%) was the primary mode of ambulatory care followed by TM video (n = 2693, 33.2%). NH Black race [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.35-0.94; P-value = 0.02], Hispanic ethnicity (OR 0.53, 95% CI 0.29-0.98; P = 0.04), public insurance (Medicaid OR 0.50, 95% CI 0.32-0.79; P = 0.003, Medicare OR 0.65, 95% CI 0.47-0.89; P = 0.009), zip-code linked median household income of <$75 000, age >85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM video encounters and a higher likelihood of in-person care.Conclusions:
Significant disparities in TM video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
Eur Heart J Digit Health
Year:
2021
Document Type:
Article
Affiliation country:
Ehjdh
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