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Disparities Identified in Telemedicine Use for Neurologic Conditions

Odds of telemedicine visit in late pandemic period lower for older adults, Blacks and Hispanics, those with higher Area Deprivation Index

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Nov. 20, 2024 (HealthDay News) — Disparities exist in telemedicine utilization for neurologic conditions, according to a study published online Nov. 20 in Neurology: Clinical Practice.

Marisa Patryce McGinley, D.O., from the Cleveland Clinic, and colleagues characterized outpatient telemedicine utilization for neurologic conditions and identified potential disparities at an academic medical health care system. Patients completing in-person visits were compared to those completing telemedicine visits. Telemedicine utilization was compared prepandemic (before March 2020), early pandemic (March to June 2020), and late pandemic (July 2020 to July 2022).

During the study time frame, 242,273 patients completed 752,174 visits. The researchers found that telemedicine utilization differed significantly between time frames, with the highest utilization early in the pandemic. The odds of a telemedicine visit were significantly lower for individuals who were older (odds ratio, 0.97), were Black or Hispanic (odds ratios, 0.84 and 0.70, respectively), had a higher Area Deprivation Index (odds ratios, 0.85, 0.80, 0.78, and 0.65 for 20 to 40, 40 to 60, 60 to 80, and ≥80 percent, respectively), had nonprivate insurance (odds ratios, 0.78, 0.84, and 0.60 for Medicaid, Medicare, and self-pay, respectively), and had non-English preferred language (odds ratio, 0.61) in the late pandemic time frame. Significantly higher odds of a telemedicine visit were seen for individuals who were female (odds ratio, 1.25) and lived outside of the greater Cleveland area (odds ratios, 2.33 and 3.32 for other Ohio and out of state, respectively). No difference was seen for visits completed by rural patients versus metropolitan patients.

“Telemedicine has the potential to improve access to neurologic care and the disparities in utilization identified in this study may aid researchers and institutions in creating strategies to ensure equitable implementation,” the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Genentech, which partially funded the study.


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