Telemedicine and Disparities in Visit Attendance at a Rural Pediatric Primary Care Clinic During the COVID-19...

Area of Science:

• Healthcare access
• Pediatric health
• Health equity

Background:

• Rural pediatric clinics often face challenges with patient visit attendance.
• Pre-existing disparities in healthcare access disproportionately affect vulnerable populations.
• The COVID-19 pandemic prompted rapid adoption of telemedicine services.

Purpose of the Study:

• To evaluate the impact of telemedicine implementation on visit attendance disparities in a rural pediatric setting.
• To determine if telemedicine reduced existing inequities in healthcare access.
• To analyze visit completion rates across different patient demographics and visit types.

Main Methods:

• Retrospective cohort study of 8,412 patients and 54,746 visits (January 2019 - December 2021).
• Categorization of visits into telemedicine, in-person urgent, and in-person non-urgent.
• Stratification of data based on pre-pandemic and pandemic response periods.

Main Results:

• Visit completion was lower for older patients, Black patients, and those with Medicaid insurance.
• Despite increased telemedicine use during the pandemic, these disparities persisted.
• No significant reduction in attendance gaps was observed post-pandemic stay-at-home orders.

Conclusions:

• Telemedicine implementation did not mitigate pre-existing disparities in pediatric clinic visit attendance.
• Further investigation is required to understand the root causes of these inequities.
• Targeted interventions are necessary to improve healthcare access for historically disadvantaged patient groups.