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Barriers Associated With Missed Palliative Care Telehealth Visits
Renato V Samala1, Paul Farah1, Wei Wei2
1Department of Palliative and Supportive Care, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
The American Journal of Hospice & Palliative Care
|September 30, 2023
Summary
Telehealth in palliative care improved access but highlighted disparities. Living in underserved areas, having multiple insurance plans, and active cancer treatment were linked to missed telehealth visits, indicating a need for equitable access measures.
Area of Science:
- Palliative Care
- Health Services Research
- Telehealth Equity
Background:
- The COVID-19 pandemic rapidly advanced telehealth adoption in palliative care settings.
- Telehealth implementation revealed significant healthcare access inequalities for socially disadvantaged populations.
Purpose of the Study:
- To pinpoint key factors contributing to missed telehealth appointments within a palliative care context.
- To analyze demographic and disease-related variables associated with telehealth visit non-attendance.
Main Methods:
- Retrospective review of telehealth visits (April 2020-March 2021) at a palliative care clinic.
- Data collection included patient demographics, disease status, and residency in community outreach zones (COZ).
- Categorization of missed visits into 'any miss' (AM) and 'pattern miss' (PM) for statistical analysis.
Main Results:
- Patients residing in COZ (underserved areas) showed a 2.56 times higher risk of pattern misses (P=.03).
- Multiple insurance coverage was associated with a 3.06 times higher risk of pattern misses (P=.006).
- Active cancer treatment increased the risk of any missed visit by 1.75 times (P=.04).
Conclusions:
- Healthcare underutilization in residential areas, active cancer treatment, and complex insurance status are significant barriers to telehealth access in palliative care.
- Targeted interventions are crucial to reduce disparities and ensure equitable access to telehealth palliative care services.
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