What are the characteristics of patients who preferred telemedicine versus in-person visits, prior to COVID-19?

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Bottom Line:

This study suggests that there are important socio-demographic differences between patients who prefer in-person primary care visits instead of telemedicine. Patients were more likely to prefer in-person visits if they were: age 65 and over, non-English speakers, and living in neighborhoods with less internet access.

Reference:

Reed, M.E. et al. Patient characteristics associated with choosing a telemedicine visit vs office visit with the same primary care clinicians. JAMA Network Open (2020). https://doi.org/10.1001/jamanetworkopen.2020.5873

Date Published:

17 June 2020

Synopsis:

The clinical symptoms of COVID-19 are wide and encompass several organ systems. In order to curb the spread of COVID-19, countries across the globe have had to adopt wide-ranging measures that limit physical contact, such as school and business closures and “stay at home” orders. Among other impacts, these measures have shifted many services to the virtual sphere, including non-urgent healthcare. This study explored the characteristics and socio-demographic factors associated with patients’ use of telemedicine in primary care (that is, physician consultations that do not require a physical exam, and can be done either over telephone or video). Although this study was conducted prior to COVID-19, the insights are extremely important in understanding which patients were most likely to opt for telemedicine beforehand, and in turn, which individuals may currently be receiving inadequate care due to, for example, discomfort with telemedicine. This study examined over 1 million patient appointments made within one large primary care health system in the U.S. Of the 1 million appointments made, 14% were telemedicine, with the vast majority being telephone (versus 7% video). Patients over 65 years of age were less likely than patients aged 18 to 44 to choose telemedicine (video or phone). Black patients were most likely to prefer either telemedicine format over in-person appointments, compared with white, Hispanic, and Asian patients. Patients living in a lower-socioeconomic status neighbourhood were significantly less likely to choose telemedicine, as were non-English speaking patients. Patients living in neighbourhoods with higher rates of internet access, as well as those with mobile device access preferred video visits, compared with in-person visits. Patients also preferred telemedicine visits if they made an appointment with their own personal primary care provider; this suggests that those without access to a designated primary care provider may feel less comfortable with, or have more difficulty accessing telemedicine services.

Summary by: Jennifer Gutberg