Assessing Racial and Ethnic Disparities in Receipt of Tele-Emergency Care

Area of Science:

• Health Services Research
• Health Equity
• Telehealth

Background:

• The Veterans Health Administration (VA) launched a Tele-Emergency Care (TEC) program in 2021 for urgent, unscheduled medical concerns.
• Early data indicate TEC effectively resolves patient concerns and reduces emergency department visits.
• The equity of TEC access across different racial and ethnic groups remains unassessed.

Purpose of the Study:

• To evaluate disparities in Tele-Emergency Care (TEC) receipt among Veterans based on race and ethnicity.

Main Methods:

• A cross-sectional study design was employed.
• Data included Veterans utilizing TEC and/or low-acuity in-person VA emergency care in the Southwestern US from March 2021 to May 2023.
• Analysis focused on the utilization of TEC and/or in-person care.

Main Results:

• Veterans receiving only TEC were less likely to be from minority racial and ethnic groups (Asian, Black, Hispanic) compared to those receiving only in-person care.
• These disparities persisted after adjusting for covariates, with significantly lower odds of TEC-only use for Asian, Black, and Hispanic Veterans compared to White Veterans.
• Specific relative risks (RR) indicated lower likelihoods: Asian (RR: 0.47), Black (RR: 0.61), and Hispanic (RR: 0.87) Veterans.

Conclusions:

• Receipt of TEC, whether exclusively or in combination with in-person care, is lower among Asian, Black, and Hispanic Veterans compared to White Veterans, independent of other factors.
• Addressing root causes of these disparities, such as digital access, triage protocols, and patient experiences, is crucial for promoting equitable care.
• Future research should focus on identifying and mitigating these barriers to ensure equitable access to Tele-Emergency Care.