Related Experiment Video
Updated: Sep 29, 2025
Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology
Published on: September 28, 2022
The Impact of Telehealth Adoption During COVID-19 Pandemic on Patterns of Pediatric Subspecialty Care Utilization
Eli M Cahan1, Jay Maturi2, Paige Bailey2
1Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif; New York University School of Medicine (EM Cahan), New York, NY.
Insights
The COVID-19 pandemic accelerated telehealth adoption in pediatric specialty care, but disparities in access and completion emerged, particularly for Hispanic patients and those with limited broadband. Further research is needed to address these social and technological variations.
Area of Science:
- Pediatric healthcare
- Telehealth utilization
- Health disparities
Background:
- The COVID-19 pandemic necessitated rapid integration of telehealth into clinical practice.
- Understanding the factors influencing telehealth adoption in pediatric subspecialty care is crucial.
Purpose of the Study:
- To examine the impact of demographics, subspecialty, and broadband availability on pediatric telehealth utilization before and after the early COVID-19 pandemic.
- To identify disparities in telehealth access and completion.
Main Methods:
- Retrospective analysis of pediatric subspecialty outpatient visits between March-June 2019 and March-June 2020.
- Multivariable regression analyses to assess the contribution of demographic, socioeconomic, and broadband factors to visit completion and telehealth utilization.
Main Results:
- Telehealth visits surged from 150 to 7,675 in 2020, while in-person visits decreased significantly.
- Completed visits were lower for Hispanic patients and those with reduced broadband access.
- Established patients, higher income, private insurance, and interpreter requests were associated with higher visit completion rates.
Conclusions:
- The rapid shift to telehealth in pediatric subspecialty care yielded mixed results regarding social disparities.
- Subspecialty variations in telehealth completion were observed.
- Addressing social and technological factors is essential for equitable telehealth implementation in diverse pediatric populations.
Objective:
The COVID-19 pandemic prompted health systems to rapidly adopt telehealth for clinical care. We examined the impact of demography, subspecialty characteristics, and broadband availability on the utilization of telehealth in pediatric populations before and after the early period of the COVID-19 pandemic.
Methods:
Outpatients scheduled for subspecialty visits at sites affiliated with a single quaternary academic medical center between March-June 2019 and March-June 2020 were included. The contribution of demographic, socioeconomic, and broadband availability to visit completion and telehealth utilization were examined in multivariable regression analyses.
Results:
Among visits scheduled in 2020 compared to 2019, in-person visits fell from 23,318 to 11,209, while telehealth visits increased from 150 to 7,675. Visits among established patients fell by 15% and new patients by 36% (P < .0001). Multivariable analysis revealed that completed visits were reduced for Hispanic patients and those with reduced broadband; high income, private non-HMO insurance, and those requesting an interpreter were more likely to complete visits. Those with visits scheduled in 2020, established patients, those with reduced broadband, and patients older than 1 year were more likely to complete TH appointments. Cardiology, oncology, and pulmonology patients were less likely to complete scheduled TH appointments.
Conclusions:
Following COVID-19 onset, outpatient pediatric subspecialty visits shifted rapidly to telehealth. However, the impact of this shift on social disparities in outpatient utilization was mixed with variation among subspecialties. A growing reliance on telehealth will necessitate insights from other healthcare settings serving populations of diverse social and technological character.
More Related Videos
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:30Current Trends in Nursing II
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:30Preventive Healthcare Services