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Analysis of Social Determinants and the Utilization of Pediatric Tele-Urgent Care During the COVID-19 Pandemic:
Saif Khairat1,2,3, Phillip McDaniel4, Matthew Jansen4
1Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC, United States.
Insights
Pediatric telehealth use doubled during COVID-19. Post-pandemic, most tele-urgent care visits were from less vulnerable areas, despite higher COVID-19 rates in vulnerable regions.
Area of Science:
- Pediatric healthcare
- Telemedicine
- Public health
Background:
- Telehealth is increasingly utilized for pediatric specialty consultations.
- The impact of the COVID-19 pandemic on telehealth use in vulnerable pediatric populations remains unclear.
Purpose of the Study:
- To compare pediatric tele-urgent care visit utilization before and after the COVID-19 pandemic.
- To assess telehealth use patterns among vulnerable pediatric populations.
Main Methods:
- Cross-sectional analysis of pediatric tele-urgent care visits from a southeastern healthcare center.
- Examined visit data from 2019 and 2020.
- Analyzed telehealth use across geographical regions with varying social disparities.
Main Results:
- Tele-urgent care visits for pediatric patients more than doubled from 2019 to 2020 (33.6% vs. 66.4%).
- Visits from areas with a high concentration of vulnerable populations constituted 17.7% of tele-urgent care visits.
- Geographic regions with high vulnerability showed a significant association with higher COVID-19 case rates.
Conclusions:
- Pediatric tele-urgent care utilization significantly increased during the COVID-19 pandemic.
- Post-pandemic, the majority of tele-urgent care visits originated from areas with fewer vulnerable populations.
- Vulnerable regions experienced disproportionately higher COVID-19 rates, highlighting potential access disparities in telehealth.
Background:
Telehealth is increasingly used to provide specialty consultations to infants and children receiving care. However, there is uncertainty if the COVID-19 pandemic has influenced the use of telehealth among vulnerable populations.
Objective:
This research aims to compare the overall use of tele-urgent care visits for pediatric patients before and after the pandemic, especially among vulnerable populations.
Methods:
We conducted a cross-sectional analysis of pediatric tele-urgent care visits at a virtual care center at a southeastern health care center. The main outcome of this study was the use of pediatrics tele-urgent visits across geographical regions with different levels of social disparities and between 2019 and 2020.
Results:
Of 584 tele-urgent care visits, 388 (66.4%) visits occurred in 2020 during the pandemic compared to 196 (33.6%) visits in 2019. Among 808 North Carolina zip codes, 181 (22%) consisted of a high concentration of vulnerable populations, where 17.7% (56/317) of the tele-urgent care visits originated from. The majority (215/317, 67.8%) of tele-urgent care visits originated from zip codes with a low concentration of vulnerable populations. There was a significant association between the rate of COVID-19 cases and the concentration level of social factors in a given Zip Code Tabulation Area.
Conclusions:
The use of tele-urgent care visits for pediatric care doubled during the COVID-19 pandemic. The majority of the tele-urgent care visits after COVID-19 originated from regions where there is a low presence of vulnerable populations. In addition, our geospatial analysis found that geographic regions with a high concentration of vulnerable populations had a significantly higher rate of COVID-19-confirmed cases and deaths compared to regions with a low concentration of vulnerable populations.
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