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Disparities in the Use of Teledermatology During the COVID-19 Pandemic Lockdown in a Pediatric Dermatology Practice
Samir Kamat1, Sumanth Chennareddy1, Tyler D'Ovidio1
1Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Insights
The COVID-19 pandemic increased telehealth use, but White patients were more likely to access these pediatric dermatology services. This shift reduced healthcare access for lower-income and Asian children.
Area of Science:
- Dermatology
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic necessitated rapid expansion of teledermatology services.
- Understanding demographic shifts in healthcare access during this period is crucial.
Purpose of the Study:
- To analyze demographic changes in a pediatric dermatology practice during the COVID-19 pandemic.
- To identify disparities in teledermatology access among children.
Main Methods:
- Retrospective chart review of pediatric dermatology patients.
- Comparison of patients seen pre-lockdown versus during COVID-19 lockdown in New York.
- Analysis of demographic data including race, age, gender, and income.
Main Results:
- The proportion of White patients increased during lockdown (59.7%) compared to pre-lockdown (43.6%).
- A significant decrease in Asian patients was observed during lockdown (6.0%) versus pre-lockdown (24.5%).
- Telehealth access was higher among White patients and those with Preferred Provider Organizations (PPO), indicating potential disparities.
Conclusions:
- Teledermatology expansion during the pandemic disproportionately benefited White patients.
- Reduced healthcare access was observed for lower-income and Asian children utilizing teledermatology.
- Findings highlight the need to address disparities in digital health equity.
Abstract:
The COVID-19 pandemic required a rapid expansion of teledermatology services. Analyze demographic shifts in a pediatric dermatology practice session with children of color. A retrospective chart review of pediatric dermatology patients seen in the 4 practice weeks preceding the New York COVID-19 lockdown and comparable teledermatology visits during the COVID-19 pandemic lockdown. Demographic differences (e.g., race, age, gender, and household income) were analyzed. A greater proportion of patients seen were White during lockdown (59.7%), compared with pre-lockdown (43.6%), with a reduction in Asian patients seen in lockdown (6.0%) compared with pre-lockdown (24.5%). A lower proportion of no-show patients (4.3%, 3/70 scheduled) were noted in lockdown compared with pre-lockdown (16%, 18/112). Preferred provider organizations (PPO) and higher-income zip codes were more common for children seen during lockdown. The sample addresses a limited New York pediatric dermatology practice during a short time period. White patients and patients with PPO were more likely to access telehealth, supporting disparity in teledermatology services. These results demonstrate reduced health care access for lower-income and Asian children during the COVID-19 pandemic lockdown.
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