Telemedicine fails to reduce, may widen disparities in cancer care, study shows
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Patients newly diagnosed with cancer and considered to be of high socioeconomic status had the highest use of telemedicine in the early days of the COVID-19 pandemic, according to a research letter published in JAMA Oncology.
“Patients with cancer cannot afford delays in their treatment. During the early months of the COVID-19 pandemic, many in-person health care visits were cancelled, and telemedicine was rapidly expanded to provide timely care for patients,” Ronald C. Chen, MD, MPH, FASCO, FASTRO, Joe and Jean Brandmeyer endowed professor and chair of the department of radiation oncology at University of Kansas Cancer Center, told Healio. “Although telemedicine has the potential to reduce disparities by broadly improving access to health care, we undertook this study to examine whether the rollout of telemedicine occurred equitably.”
Researchers pooled data from the HealthCore Integrated Research Database on 16,006 patients (53% men; 50.7% aged 18 to 64 years) with newly diagnosed breast, lung, prostate or colorectal cancer between Jan. 1 and Aug. 31, 2020.
Receipt of a telemedicine visit within 30 days of cancer diagnosis, which the researchers established with the presence of one or more claims with Current Procedural Terminology of Healthcare Common Procedure Coding Systems codes for telemedicine services, served as the primary outcome.
According to study results, the rate of telemedicine visits increased from 0.4% in January to a peak of 54% in April.
Researchers noted socioeconomic status differences in the patterns of telemedicine uptake, with approximately 66.9% of patients in the highest socioeconomic status index quartile having a telemedicine visit within 30 days of cancer diagnosis compared with 47.4% to 48.6% of patients in the lower socioeconomic quartiles.
Results of multivariable analysis showed that compared with patients in the lowest socioeconomic status index quartile, those in the highest quartile had 31% higher odds of telemedicine use within 30 days of cancer diagnosis (risk ratio = 1.31; 95% CI, 1.17-1.47).
“Unequal utilization of telemedicine among [patients with cancer] across the U.S. may widen cancer disparities. Now that telemedicine is no longer new, further studies can examine whether socioeconomic status differences in its use persist,” Chen said. “Additional studies can examine whether less telemedicine use is associated with delayed cancer care and worse outcomes for certain groups of patients.”
For more information:
Ronald C. Chen, MD, MPH, FASCO, FASTRO, can be reached at University of Kansas Cancer Center, Richard and Annette Bloch Cancer Care Pavilion, 2650 Shawnee Mission Parkway, Westwood, KS 66205.
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