The Geography of Disconnection: Rural and Urban Gaps in Post-Pandemic Telehealth Use

Area of Science:

• Public Health
• Health Services Research
• Rural Health

Background:

• Telehealth adoption surged during the COVID-19 pandemic.
• Understanding post-pandemic telehealth utilization patterns is crucial for equitable healthcare access.
• Rural-urban disparities in healthcare access are a persistent concern.

Purpose of the Study:

• To examine rural-urban disparities in telehealth utilization after the pandemic.
• To assess if these disparities persist after accounting for individual characteristics.
• To identify reasons for telehealth non-use among rural populations.

Main Methods:

• Analysis of 2022 and 2024 Health Information National Trends Survey (HINTS) data.
• Multivariable logistic regression to adjust for covariates.
• Propensity score matching to estimate differences in telehealth use by rurality.

Main Results:

• Overall telehealth use was 38.7% in the past 12 months.
• Rural residents were significantly less likely to use telehealth compared to urban residents.
• Rural non-users more frequently reported not being offered telehealth, suggesting delivery-side barriers.

Conclusions:

• Significant rural-urban disparities in telehealth use persist post-pandemic.
• Delivery-side barriers, including lack of telehealth offerings, contribute to lower utilization in rural areas.
• Addressing these disparities is essential for achieving equitable telehealth access.