Telehealth use in orthopedics varied based on patient, insurance factors
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Use of telehealth in orthopedics varied among patients based on race or ethnicity, primary language and insurance type, according to published results.
Andrew J. Schoenfeld, MD, MSc, and colleagues compared 1,760 new patients who received orthopedic care through outpatient telehealth between March 2020 and May 2020 with 9,296 patients who received in-person orthopedic care during the same period in 2019. Researchers considered patient self-reported race or ethnicity as the primary independent variable, and primary language and insurance status as secondary variables. Researchers performed unadjusted and multivariable adjusted analyses for the primary and secondary predictors using logistic regression, and also assessed interactions between race or ethnicity, primary language and insurance type.
After adjusting for age, gender, subspecialty, insurance and median household income, investigators found patients who identified as Hispanic or Asian were less likely to be seen through telehealth compared with patients who identified as white. After controlling for confounding variables, researchers also found patients were less likely to have a telehealth visit if they spoke a language other than English or Spanish. Patients were less likely to be seen through a telehealth visit if they were insured through Medicaid, according to results.
“As health care moves toward increased telemedicine use, we suggest several approaches to ensure that patients racial and ethnic minorities, as well as those of certain language groups do not experience barriers to orthopedic care,” Schoenfeld told Healio Orthopedics. “These might include individual patient- or provider-level approaches, like expanded telemedicine schedules to accommodate weekends and evenings, institutional investment in culturally conscious outreach materials and government-level provisions, such as reimbursement for telephone-only encounters.”
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