Assessing Patient Demographics Associated with Telehealth and In-Person Contraceptive Care at a Tertiary Care...

Objective: To describe the patient population accessing in-person versus telehealth contraceptive care and to identify demographic disparities in telehealth care utilization. Design: We conducted a retrospective chart review of patients accessing telehealth and in-person contraceptive care at an academic health center between January 1, 2021, and December 31, 2021. Billing data were used to identify medical records for patients aged 18-54 who had a contraceptive visit during this time. Demographic and past medical history were collected from the electronic health record. Results: A total of 1,435 unique patients were included. Of 1,691 total visits, 16% were telehealth visits. Being publicly insured was significantly associated with decreased likelihood of having a telehealth visit compared with an in-person visit and remained so after adjusting for race, marital status, and language (adjusted risk ratio [aRR]: 0.51, confidence interval [CI]: 0.33-0.78). Individuals aged 45 years and older were less likely to have telehealth visits (aRR: 0.52, CI: 0.27-1.02). Being single was positively associated with accessing telehealth contraceptive care (aRR: 1.57, CI: 1.06-2.23). There were no statistically significant associations by race or ethnicity. Intrauterine devices were the most commonly prescribed contraceptive type after an in-person visit (35%) while oral contraceptives were the most commonly prescribed after telehealth visits (37%). Conclusions: Our study found decreased utilization of telehealth for contraceptive care among patients who are publicly insured and older than 45. We found no differences in the use of telehealth for contraceptive care by race, ethnicity, or language. Telehealth is a powerful tool with the potential to increase equity in health care. It is important to continue research to understand how patient demographics affect use of telehealth for contraceptive care to facilitate more equitable access.