Analysis of Social Determinants and the Utilization of Pediatric Tele–Urgent Care During the COVID-19 Pandemic: Cross-sectional Study

BACKGROUND: Telehealth is increasingly used to provide specialty consultations to infants and children receiving care. However, there is uncertainty if the COVID-19 pandemic has influenced the use of telehealth among vulnerable populations. OBJECTIVE: This research aims to compare the overall use of tele–urgent care visits for pediatric patients before and after the pandemic, especially among vulnerable populations. METHODS: We conducted a cross-sectional analysis of pediatric tele–urgent care visits at a virtual care center at a southeastern health care center. The main outcome of this study was the use of pediatrics tele–urgent visits across geographical regions with different levels of social disparities and between 2019 and 2020. RESULTS: Of 584 tele–urgent care visits, 388 (66.4%) visits occurred in 2020 during the pandemic compared to 196 (33.6%) visits in 2019. Among 808 North Carolina zip codes, 181 (22%) consisted of a high concentration of vulnerable populations, where 17.7% (56/317) of the tele–urgent care visits originated from. The majority (215/317, 67.8%) of tele–urgent care visits originated from zip codes with a low concentration of vulnerable populations. There was a significant association between the rate of COVID-19 cases and the concentration level of social factors in a given Zip Code Tabulation Area. CONCLUSIONS: The use of tele–urgent care visits for pediatric care doubled during the COVID-19 pandemic. The majority of the tele–urgent care visits after COVID-19 originated from regions where there is a low presence of vulnerable populations. In addition, our geospatial analysis found that geographic regions with a high concentration of vulnerable populations had a significantly higher rate of COVID-19–confirmed cases and deaths compared to regions with a low concentration of vulnerable populations.