Telehealth Utilization Patterns Among Patients with Chronic Conditions Across Age, Gender, Geography, and Insurance...

Telehealth utilization patterns have been variably studied across diabetes, hyperlipidemia, and asthma settings. This study aims to evaluate telehealth patterns in these disease settings through the COVID-19 pandemic across age, gender, geography, and insurance dimensions.

We identified patients with asthma, diabetes, or hyperlipidemia aged 18-64 with commercial or Medicaid insurance between 2017 and 2022 using Arkansas All-Payer Claims Database (APCD) data. The primary outcome variable was an indicator for any telehealth use. We plotted telehealth visits by quarter for each disease state by age, gender, rurality, and insurance strata. We also conducted linear regression analyses to associate telehealth use with each year relative to 2019 while controlling for patient characteristics.

Telehealth was seldom used pre-pandemic but sharply increased during the pandemic, reaching 11.8% in asthma, 9.1% in diabetes, and 9.0% in hyperlipidemia. Following the pandemic (2020-2022), females, urban residents, and younger patients were generally more likely to utilize telehealth. In adjusted analyses, relative to 2019, telehealth use sharply increased in 2020 between 12.7 and 15.1 percentage points (all p < 0.05) across the conditions. Utilization dipped in later years but remained much higher than prepandemic levels with the largest increases being among patients with asthma.

These findings suggest that differences in telehealth adoption are not solely and uniformly attributable to observable patient characteristics but may also reflect structural and clinical factors particular to patient demographics and the specific disease setting. Ongoing efforts should support clinically-appropriate, even, and sustained access across groups.