TY - JOUR
AU - A. A. Tierney
AU - J. Huang
AU - A. Gopalan
AU - E. Muelly
AU - I. Graetz
AU - L. Hsueh
AU - M. E. Reed
A1 - 
AB - BACKGROUND: Future telemedicine reimbursement is uncertain. Knowing which patients may be most reliant on telemedicine can help assess its value. OBJECTIVE: To identify the patient characteristics associated with using only telemedicine for primary care. DESIGN: Cross-sectional observational study of individuals who had multiple primary care visits in 2022. PATIENTS: A total of 1,151,984 adult patients with two or more primary care visits seeking care at a large integrated health system in Northern California in 2022. MAIN MEASURES: Primary care visit modality (only telemedicine, or any in-person); associations (in adjusted percentages) between characteristics and the likelihood of accessing primary care via telemedicine only. KEY RESULTS: Most patients (n = 812,581, 70.5%) used telemedicine in 2022, with 55.1% (n = 635,208) having both telemedicine and in-person visits, and 15.4% (n = 117,373) having only telemedicine visits. As adjusted percentages, 23.5% of patients 18-44 years old (95% CI, 23.3-23.6%) used only telemedicine primary care visits, a significantly higher proportion than younger (< 18-4.7%; 95% CI 4.6-4.8%) or older age groups (45-64-17.6%; 95% CI 17.5-17.8%; 65-74-13.4%; 95% CI 13.2-13.5%; 75 + -14.5%, 95% CI 14.3-14.7%). Patients who were female (16.6%, CI 16.5-16.7% vs. male 13.8%, 95% CI 13.8-13.9%), Black (17.0%, 95% CI 16.9-17.3% vs. White 15.5%, 95% CI 15.4-15.6%), living in low-SES neighborhoods (15.8%, 95% CI 15.6-15.9% vs. higher 15.4%, 95% CI 15.3-15.4%), with longer drive times to clinic (11-20 min-15.4%, 95% CI 15.3-15.5%; 20 + min-17.7%, 95% CI 17.5-17.8%) or with a clinic parking fee (16.7%, 95% CI 16.5-17.0% vs. free 15.3%, 95% CI 15.2-15.4%) were more likely to only use telemedicine to access primary care. CONCLUSIONS: Telemedicine may have facilitated access to primary care for patients that have barriers to in-person care.
AD - Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA. Aaron.a.tierney@kp.org.; Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.; The Permanente Medical Group, Santa Clara, CA, USA.; Rollins School of Public Health, Emory University, Atlanta, GA, USA.; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.
AN - 40760372
BT - J Gen Intern Med
C5 - HIT & Telehealth
CP - 14
DA - Nov
DO - 10.1007/s11606-025-09770-6
DP - NLM
ET - 20250804
IS - 14
JF - J Gen Intern Med
LA - eng
N2 - BACKGROUND: Future telemedicine reimbursement is uncertain. Knowing which patients may be most reliant on telemedicine can help assess its value. OBJECTIVE: To identify the patient characteristics associated with using only telemedicine for primary care. DESIGN: Cross-sectional observational study of individuals who had multiple primary care visits in 2022. PATIENTS: A total of 1,151,984 adult patients with two or more primary care visits seeking care at a large integrated health system in Northern California in 2022. MAIN MEASURES: Primary care visit modality (only telemedicine, or any in-person); associations (in adjusted percentages) between characteristics and the likelihood of accessing primary care via telemedicine only. KEY RESULTS: Most patients (n = 812,581, 70.5%) used telemedicine in 2022, with 55.1% (n = 635,208) having both telemedicine and in-person visits, and 15.4% (n = 117,373) having only telemedicine visits. As adjusted percentages, 23.5% of patients 18-44 years old (95% CI, 23.3-23.6%) used only telemedicine primary care visits, a significantly higher proportion than younger (< 18-4.7%; 95% CI 4.6-4.8%) or older age groups (45-64-17.6%; 95% CI 17.5-17.8%; 65-74-13.4%; 95% CI 13.2-13.5%; 75 + -14.5%, 95% CI 14.3-14.7%). Patients who were female (16.6%, CI 16.5-16.7% vs. male 13.8%, 95% CI 13.8-13.9%), Black (17.0%, 95% CI 16.9-17.3% vs. White 15.5%, 95% CI 15.4-15.6%), living in low-SES neighborhoods (15.8%, 95% CI 15.6-15.9% vs. higher 15.4%, 95% CI 15.3-15.4%), with longer drive times to clinic (11-20 min-15.4%, 95% CI 15.3-15.5%; 20 + min-17.7%, 95% CI 17.5-17.8%) or with a clinic parking fee (16.7%, 95% CI 16.5-17.0% vs. free 15.3%, 95% CI 15.2-15.4%) were more likely to only use telemedicine to access primary care. CONCLUSIONS: Telemedicine may have facilitated access to primary care for patients that have barriers to in-person care.
PY - 2025
SN - 0884-8734 (Print); 0884-8734
SP - 3363
EP - 3370+
ST - Telemedicine and Primary Care Access: A Cross-sectional Observational Study of Patients Using Only Telemedicine
T1 - Telemedicine and Primary Care Access: A Cross-sectional Observational Study of Patients Using Only Telemedicine
T2 - J Gen Intern Med
TI - Telemedicine and Primary Care Access: A Cross-sectional Observational Study of Patients Using Only Telemedicine
U1 - HIT & Telehealth
U3 - 10.1007/s11606-025-09770-6
VL - 40
VO - 0884-8734 (Print); 0884-8734
Y1 - 2025
ER -