TY - JOUR
AU - E. Weber
AU - S. J. Miller
AU - N. Shroff
AU - M. Beyrouty
AU - N. Calman
A1 - 
AB - Objective: To explore overall trends as well as racial/ethnic disparities in utilization of different telehealth modalities (telephone vs. televideo) at federally qualified health centers (FQHCs) during the COVID-19 pandemic. Methods: Using electronic health record data from a large New York-based FQHC system, we aggregated (separately) Behavioral Health and Family Practice visits per month occurring in-person, by telephone, or by televideo and graphed monthly trends in visits across the pre-pandemic, peak-pandemic, and post-peak-pandemic periods. We calculated fractions of visits conducted by modality for each patient demographic (race/ethnicity, primary language, age, gender, insurance type, and geography) and conducted bivariate assessments to test relationships between patient characteristics and modality. Results: Our data contained 121,072 unique patients and 811,105 visits overall. Telehealth use peaked in April 2020 but continued to account for a significant fraction of FQHC visits-nearly 25% (N = 4,908) of monthly Family Practice visits and a massive 98% (N = 14,173) of Behavioral Health visits as late as June 2021. Of all telehealth visits, nearly half were by telephone. Moreover, demographic factors differed between FQHC patients using telephone visits versus those using televideo: Black, non-English speaking, older, and Medicaid patients had significantly higher utilization of telephone visits than televideo visits (e.g., 25.9% of all Black patients' visits were via telephone vs. 17.1% via televideo; p < 0.001). In contrast, younger, Asian, and privately insured patients had significantly higher televideo visits. Conclusions: Our results suggest that telephone visits remain critical to the provision of health care for FQHC patients. They also suggest that disparities extend beyond the telehealth versus in-person dichotomy and inequities exist even within the type of telehealth used. This has implications for patient health, FQHC quality outcomes, as well as optimal Medicaid telehealth reimbursement policy.
AD - Department of Population Health Science and Policy, Icahn School of Medicine, New York, New York, USA.; Department of Family Medicine and Community Health, Icahn School of Medicine, New York, New York, USA.; The Institute for Family Health, New York, New York, USA.
AN - 36961396
BT - Telemed J E Health
C5 - HIT & Telehealth; Education & Workforce; Healthcare Disparities; Financing & Sustainability
CP - 11
DA - Nov
DO - 10.1089/tmj.2022.0511
DP - NLM
ET - 20230324
IS - 11
JF - Telemed J E Health
LA - eng
N2 - Objective: To explore overall trends as well as racial/ethnic disparities in utilization of different telehealth modalities (telephone vs. televideo) at federally qualified health centers (FQHCs) during the COVID-19 pandemic. Methods: Using electronic health record data from a large New York-based FQHC system, we aggregated (separately) Behavioral Health and Family Practice visits per month occurring in-person, by telephone, or by televideo and graphed monthly trends in visits across the pre-pandemic, peak-pandemic, and post-peak-pandemic periods. We calculated fractions of visits conducted by modality for each patient demographic (race/ethnicity, primary language, age, gender, insurance type, and geography) and conducted bivariate assessments to test relationships between patient characteristics and modality. Results: Our data contained 121,072 unique patients and 811,105 visits overall. Telehealth use peaked in April 2020 but continued to account for a significant fraction of FQHC visits-nearly 25% (N = 4,908) of monthly Family Practice visits and a massive 98% (N = 14,173) of Behavioral Health visits as late as June 2021. Of all telehealth visits, nearly half were by telephone. Moreover, demographic factors differed between FQHC patients using telephone visits versus those using televideo: Black, non-English speaking, older, and Medicaid patients had significantly higher utilization of telephone visits than televideo visits (e.g., 25.9% of all Black patients' visits were via telephone vs. 17.1% via televideo; p < 0.001). In contrast, younger, Asian, and privately insured patients had significantly higher televideo visits. Conclusions: Our results suggest that telephone visits remain critical to the provision of health care for FQHC patients. They also suggest that disparities extend beyond the telehealth versus in-person dichotomy and inequities exist even within the type of telehealth used. This has implications for patient health, FQHC quality outcomes, as well as optimal Medicaid telehealth reimbursement policy.
PY - 2023
SN - 1530-5627
SP - 1601
EP - 1612+
ST - Recent Telehealth Utilization at a Large Federally Qualified Health Center System: Evidence of Disparities Even Within Telehealth Modalities
T1 - Recent Telehealth Utilization at a Large Federally Qualified Health Center System: Evidence of Disparities Even Within Telehealth Modalities
T2 - Telemed J E Health
TI - Recent Telehealth Utilization at a Large Federally Qualified Health Center System: Evidence of Disparities Even Within Telehealth Modalities
U1 - HIT & Telehealth; Education & Workforce; Healthcare Disparities; Financing & Sustainability
U3 - 10.1089/tmj.2022.0511
VL - 29
VO - 1530-5627
Y1 - 2023
ER -