Comparison of Telemedicine Usage at Two Distinct Medicaid-Focused Pediatric Clinics

Area of Science:

• Pediatric Primary Care
• Health Services Research
• Telemedicine and Digital Health

Background:

• Telemedicine adoption surged during the COVID-19 pandemic, particularly in primary care settings.
• Understanding disparities in telemedicine access among vulnerable populations, such as Medicaid enrollees, is crucial for equitable healthcare delivery.
• Previous research indicates potential disparities in digital health tool utilization based on demographics.

Purpose of the Study:

• To compare telemedicine versus in-office visit utilization in two Medicaid-focused pediatric primary care clinics.
• To identify patient demographic factors associated with telemedicine use.
• To explore differences in telemedicine access across various visit types and patient populations.

Main Methods:

• A retrospective cohort study analyzed 17,142 visits from March 2020 to March 2021 across two distinct pediatric clinics serving Medicaid populations.
• Outcomes included the percentage of visits conducted via telemedicine and the reasons for visits.
• Statistical analyses, including multivariable logistic regression, were employed to assess the relationship between patient demographics and telemedicine utilization.

Main Results:

• Overall, 13% of visits at Site A and 25% at Site B utilized telemedicine.
• Telemedicine was used for 13.8% of well-child visits, 36.2% of mental health visits, and 25.0% of acute care/follow-up visits.
• While preferred language and payor were not associated with telemedicine use, younger children (1-4 years) had lower odds. Site A showed lower telemedicine use among Non-Hispanic Black, Hispanic/Latinx, and other race/ethnicity groups compared to Non-Hispanic White patients.

Conclusions:

• Telemedicine was successfully utilized by Medicaid enrollees for diverse pediatric primary care needs.
• No disparities in telemedicine use were observed based on preferred language or payor status.
• Significant differences in telemedicine access were noted by age and, at one site, by race/ethnicity, highlighting the need for targeted interventions to ensure equitable access for marginalized groups.