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Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Rockholt, Mika LU orcid ; Addae, Gifty ; Chee, Alexander ; Chin, Wanda ; Cuff, Germaine ; Wang, Jing ; Umeh, Uchenna O and Doan, Lisa V. (2023) In Journal of Pain Research 16. p.2763-2775
Abstract
Purpose: The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.
Patients and methods: All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race,... (More)
Purpose: The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.
Patients and methods: All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) – were analyzed and compared.
Results: In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p < 0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p < 0.05).
Conclusion: We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.
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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
Journal of Pain Research
volume
16
pages
2763 - 2775
publisher
Dove Medical Press Ltd.
external identifiers
  • pmid:37577160
  • scopus:85167926677
ISSN
1178-7090
DOI
10.2147/JPR.S415415
language
English
LU publication?
no
id
0ffbc49c-b387-4183-ac57-1049d5de8d90
date added to LUP
2023-10-03 18:02:18
date last changed
2023-10-04 07:59:56
@article{0ffbc49c-b387-4183-ac57-1049d5de8d90,
  abstract     = {{Purpose: The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.<br/>Patients and methods: All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) – were analyzed and compared.<br/>Results: In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p &lt; 0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p &lt; 0.05).<br/>Conclusion: We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.<br/>}},
  author       = {{Rockholt, Mika and Addae, Gifty and Chee, Alexander and Chin, Wanda and Cuff, Germaine and Wang, Jing and Umeh, Uchenna O and Doan, Lisa V.}},
  issn         = {{1178-7090}},
  language     = {{eng}},
  month        = {{08}},
  pages        = {{2763--2775}},
  publisher    = {{Dove Medical Press Ltd.}},
  series       = {{Journal of Pain Research}},
  title        = {{Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice}},
  url          = {{http://dx.doi.org/10.2147/JPR.S415415}},
  doi          = {{10.2147/JPR.S415415}},
  volume       = {{16}},
  year         = {{2023}},
}