Telehealth Utilization and Patient Experiences: Patterns of Social Determinants of Health Among Individuals With Hypertension and Diabetes

Telehealth has become a critical modality for managing chronic diseases like hypertension and diabetes. Understanding utilization patterns, effectiveness, and how social determinants of health (SDOH) influence access is essential for promoting equitable care in diverse populations.

The purpose of this study was to evaluate telehealth utilization, effectiveness, and patient satisfaction among individuals with hypertension and/or diabetes, and examine how SDOH relate to telehealth access across sociodemographic groups in the United States.

We conducted a cross-sectional analysis of the 2022 Health Information National Trends Survey 6. Telehealth use was measured across 14 survey items. Participants were categorized as having diabetes only, hypertension only, or both. Weighted analyses used Taylor series methods with appropriate statistical tests and multiple comparison adjustments.

Of 6,252 respondents, 3,009 met inclusion criteria. Overall telehealth utilization was 43.9%. Participants with both conditions were significantly older, more likely to be retired, and had lower income and education compared to single-condition groups. Telehealth modality differed across groups: the comorbid group had the highest phone-only use (21.4%), while the diabetes-only group had the highest video-only use (21.4%). Telehealth was offered to only 13.2% to 21.5% of participants. No significant differences were found in technical difficulties, perceived care quality, or privacy concerns. SDOH challenges including food insecurity, transportation barriers, and lower education were most concentrated in the comorbid group.

Despite bearing the greatest SDOH burden, the comorbid group showed the highest utilization, likely reflecting care burden rather than equitable access, reinforced by disproportionate reliance on phone-only visits. Targeted interventions addressing digital access and SDOH barriers are needed to ensure equitable telehealth delivery.