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Telemedicine for Children With Cerebral Palsy Before, During, and After the COVID-19 Pandemic: An Australian Cohort
Simon P Paget1,2, Sarah McIntyre3, Amy von Huben4
1The Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Insights
Telemedicine use in children with cerebral palsy increased during the COVID-19 pandemic but declined afterward. Further support is needed to maintain these vital telehealth services for pediatric cerebral palsy care.
Area of Science:
- Pediatric healthcare
- Telemedicine utilization
- Cerebral palsy research
Background:
- Cerebral palsy (CP) requires ongoing specialist care.
- The COVID-19 pandemic significantly altered healthcare delivery models.
- Understanding telemedicine's role in CP care is crucial.
Purpose of the Study:
- To analyze telemedicine use in children with cerebral palsy.
- To compare telemedicine adoption before, during, and after the COVID-19 pandemic.
- To identify factors influencing telemedicine use in pediatric CP care.
Main Methods:
- Retrospective cohort study of 1162 children with cerebral palsy (2005-2017 birth years).
- Analysis of 48,896 outpatient visits from January 2018 to May 2023.
- Categorization of visits as in-person or telemedicine, comparing pre-, during, and post-pandemic periods.
Main Results:
- Telemedicine accounted for 24.4% of outpatient encounters.
- Telemedicine rates peaked during the pandemic (20.2/month) and decreased post-pandemic (15.2/month).
- Higher socioeconomic disadvantage correlated with increased telemedicine use; regional/remote children had lower rates.
Conclusions:
- Telemedicine use in pediatric cerebral palsy care has decreased since pandemic restrictions eased.
- Sustaining telemedicine requires targeted support and learning from pandemic-driven adaptations.
- Equitable access to telemedicine for children with CP needs further investigation.
Abstract:
Objective: To examine telemedicine use in children with cerebral palsy before, during and since the COVID-19 pandemic. Methods: A retrospective cohort study of 1162 children with cerebral palsy (40.3% female, birth years 2005-2017), attending specialist outpatient clinics at 2 pediatric hospitals in New South Wales, Australia. We categorized outpatient visits from January 2018 to May 2023 as in-person or telemedicine and compared usage pre-, during, and post-COVID-19 periods. Neighborhood socioeconomic disadvantage and geographical remoteness were defined by residential postcode. Results: Of 48 896 outpatient encounters, 11 929 (24.4%) used telemedicine. Telemedicine rates increased during COVID-19 (20.2 per 100 persons/month) and declined post-COVID-19 (15.2 per 100 persons/month, P < .001). Neighborhood socioeconomic disadvantage was associated with higher median outpatient and telemedicine encounter rates. Regional/remote children had lower median outpatient and telemedicine rates. Conclusion: Telemedicine use declined since lifting of COVID-19 pandemic restrictions. Further support will be required to sustain rates and learn from pandemic experiences.
