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Telemedicine Adoption during the COVID-19 Pandemic: Gaps and Inequalities. Appl Clin Inform 2021 Aug;12(4):836-844



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2-s2.0-85114767728   19 Citations


BACKGROUND: The telemedicine industry has been experiencing fast growth in recent years. The outbreak of coronavirus disease 2019 (COVID-19) further accelerated the deployment and utilization of telemedicine services. An analysis of the socioeconomic characteristics of telemedicine users to understand potential socioeconomic gaps and disparities is critical for improving the adoption of telemedicine services among patients.

OBJECTIVES: This study aims to measure the correlation of socioeconomic determinants with the use of telemedicine services in Milwaukee metropolitan area.

METHODS: Electronic health record review of patients using telemedicine services compared with those not using telemedicine services within an academic-community health system: patient demographics (e.g., age, gender, race, and ethnicity), insurance status, and socioeconomic determinants obtained through block-level census data in Milwaukee area. The telemedicine users were compared with all other patients using regression analysis. The telemedicine adoption rates were calculated across regional ZIP codes to analyze the geographic patterns of telemedicine adoption.

RESULTS: A total of 104,139 patients used telemedicine services during the study period. Patients who used video visits were younger (median age 48.12), more likely to be White (odds ratio [OR] 1.34; 95% confidence interval [CI], 1.31-1.37), and have private insurance (OR 1.43; CI, 1.41-1.46); patients who used telephone visits were older (median age 57.58), more likely to be Black (OR 1.31; CI 1.28-1.35), and have public insurance (OR 1.30; CI 1.27-1.32). In general, Latino and Asian populations were less likely to use telemedicine; women used more telemedicine services in general than men. In the multiple regression analysis of social determinant factors across 126 ZIP codes, college education (coefficient 1.41, p = 0.01) had a strong correlation to video telemedicine adoption rate.

CONCLUSION: Adoption of telemedicine services was significantly impacted by the social determinant factors of health, such as income, education level, race, and insurance type. The study reveals the potential inequities and disparities in telemedicine adoption.

Author List

Luo J, Tong L, Crotty BH, Somai M, Taylor B, Osinski K, George B


Bradley H. Crotty MD Associate Professor in the Medicine department at Medical College of Wisconsin
Ben George MD Associate Professor in the Medicine department at Medical College of Wisconsin
Jake Luo Ph.D. Associate Professor; Director, Center for Biomedical Data and Language Processing (BioDLP) in the Health Informatics & Administration department at University of Wisconsin - Milwaukee
Melek Somai MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Bradley W. Taylor Chief Research Informatics Officer in the Clinical and Translational Science Institute department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Electronic Health Records
Middle Aged