Evaluation of Geographic Trends in Plastic Surgery Telemedicine Utilization

Recent studies have suggested that telemedicine expansions during the coronavirus disease 2019 public health emergency may expand subspecialty care access to remote areas. However, the geographic distribution of telemedicine usage within plastic surgery remains unclear. This study evaluated patients' use of telemedicine by travel distance.

A retrospective cohort study was conducted on surgery patients who were seen at a large academic institution between 2020 and 2023. Travel distances were calculated between patients' home addresses and the primary academic center. Univariate analyses and multivariable regression were performed.

In total, 57,895 patients were included. This included 5445 plastic surgery patients, of which 304 patients (5.58%) utilized telemedicine. Among plastic surgery patients, mean travel distance did not significantly differ by telemedicine usage (121.24 miles versus 158.88 miles, P = 0.22). Gender identification as female (odds ratio [OR] 1.70, 95% confidence interval [CI] [1.13, 2.63], P = 0.014) or "other" (OR 3.18, 95% CI [1.34, 6.98], P = 0.006) were associated with increased telemedicine use compared to male patients. Patients who identified as Black or African American had higher rates of telemedicine use (OR 1.54 [95% CI 1.14, 2.06], P = 0.004), while Medicare insurance (OR 0.62 [95% CI 0.40, 0.95], P = 0.031) or self-payer status (OR 0.29 [95% CI 0.19, 0.41], P < 0.001) predicted decreased telemedicine use. Among surgical specialties, plastic surgery patients had the lowest rates of telemedicine utilization.

Plastic surgery patients' usage of telemedicine was not significantly associated with travel distance but may be influenced by other sociodemographic and clinical factors.