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Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations
OBJECTIVE: The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in the use of telemedicine across all medical fields but has also exposed telehealth care disparities with differing access to technology across racial and ethnic groups. The objective of our study was to invest...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
by the Society for Vascular Surgery. Published by Elsevier Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652098/ https://www.ncbi.nlm.nih.gov/pubmed/36375724 http://dx.doi.org/10.1016/j.jvs.2022.11.039 |
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author | Abou Ali, Adham N. Abdul Malak, Othman M. Hafeez, Muhammad Saad Habib, Salim Cherfan, Patrick Salem, Karim M. Hager, Eric Avgerinos, Efthymios Sridharan, Natalie |
author_facet | Abou Ali, Adham N. Abdul Malak, Othman M. Hafeez, Muhammad Saad Habib, Salim Cherfan, Patrick Salem, Karim M. Hager, Eric Avgerinos, Efthymios Sridharan, Natalie |
author_sort | Abou Ali, Adham N. |
collection | PubMed |
description | OBJECTIVE: The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in the use of telemedicine across all medical fields but has also exposed telehealth care disparities with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the effects of telehealth on vascular visit compliance and to explore the effects of sociodemographic factors on vascular surgery outpatient telehealth usage during the COVID-19 pandemic. METHODS: Consecutive patients who had undergone an outpatient vascular surgery evaluation between February 24, 2020 (the launch of our telemedicine program) and December 31, 2020, were reviewed. The baseline demographic and outcomes were obtained from the electronic medical records. Telehealth and in-person evaluations were defined according to the patient’s index visit during the study period. Medical visit compliance was established on completion of the telehealth or in-person encounter. We used χ(2) tests and logistic regression analyses. RESULTS: A total of 23,553 outpatient visits had been scheduled for 10,587 patients during the study period. Of the outpatient visits, 1559 had been scheduled telehealth encounters compared with 21,994 scheduled in-person encounters. Of the scheduled outpatient encounters, 13,900 medical visits (59.0%) had been completed: 1183 telehealth visits and 12,717 in-person visits. The mean travel distance saved for the telehealth visits was 22.1 ± 27.1 miles, and the mean travel time saved was 46.3 ± 41.47 minutes. We noted no sociodemographic differences between the patients scheduled for telehealth vs in-person visits. We found a trend toward a lower proportion of African-American patients in the telehealth group vs the in-person group (7.8% vs 10.6%; P = .116), without statistical significance. A significantly higher rate of medical visit completion was found for the telehealth group compared with the in-person group (79.5% vs 59.4%; P < .001). Among the patients scheduled for an outpatient medical visit, a scheduled telemedicine evaluation (vs in-person) was associated with 2.3 times the odds of completing the medical visit (odds ratio, 2.31; 95% confidence interval, 2.05-2.61), adjusting for age, sex, race, ethnicity, language, and the distance between the patient’s home zip code and the outpatient vascular center’s zip code. Selecting for scheduled telemedicine visits, African-American race was associated with a decreased odds of telemedicine usage (odds ratio, 0.73; 95% confidence interval, 0.59-0.90) after adjusting for age, sex, ethnicity, language, and visit type. CONCLUSIONS: Use of the vascular surgery outpatient telehealth evaluation appeared to improve medical visit completion in our region with apparent sociodemographic disparities. Further studies are needed to confirm whether telemedicine expansion has improved access to care in other geographic areas. |
format | Online Article Text |
id | pubmed-9652098 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | by the Society for Vascular Surgery. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96520982022-11-15 Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations Abou Ali, Adham N. Abdul Malak, Othman M. Hafeez, Muhammad Saad Habib, Salim Cherfan, Patrick Salem, Karim M. Hager, Eric Avgerinos, Efthymios Sridharan, Natalie J Vasc Surg Practice Management OBJECTIVE: The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in the use of telemedicine across all medical fields but has also exposed telehealth care disparities with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the effects of telehealth on vascular visit compliance and to explore the effects of sociodemographic factors on vascular surgery outpatient telehealth usage during the COVID-19 pandemic. METHODS: Consecutive patients who had undergone an outpatient vascular surgery evaluation between February 24, 2020 (the launch of our telemedicine program) and December 31, 2020, were reviewed. The baseline demographic and outcomes were obtained from the electronic medical records. Telehealth and in-person evaluations were defined according to the patient’s index visit during the study period. Medical visit compliance was established on completion of the telehealth or in-person encounter. We used χ(2) tests and logistic regression analyses. RESULTS: A total of 23,553 outpatient visits had been scheduled for 10,587 patients during the study period. Of the outpatient visits, 1559 had been scheduled telehealth encounters compared with 21,994 scheduled in-person encounters. Of the scheduled outpatient encounters, 13,900 medical visits (59.0%) had been completed: 1183 telehealth visits and 12,717 in-person visits. The mean travel distance saved for the telehealth visits was 22.1 ± 27.1 miles, and the mean travel time saved was 46.3 ± 41.47 minutes. We noted no sociodemographic differences between the patients scheduled for telehealth vs in-person visits. We found a trend toward a lower proportion of African-American patients in the telehealth group vs the in-person group (7.8% vs 10.6%; P = .116), without statistical significance. A significantly higher rate of medical visit completion was found for the telehealth group compared with the in-person group (79.5% vs 59.4%; P < .001). Among the patients scheduled for an outpatient medical visit, a scheduled telemedicine evaluation (vs in-person) was associated with 2.3 times the odds of completing the medical visit (odds ratio, 2.31; 95% confidence interval, 2.05-2.61), adjusting for age, sex, race, ethnicity, language, and the distance between the patient’s home zip code and the outpatient vascular center’s zip code. Selecting for scheduled telemedicine visits, African-American race was associated with a decreased odds of telemedicine usage (odds ratio, 0.73; 95% confidence interval, 0.59-0.90) after adjusting for age, sex, ethnicity, language, and visit type. CONCLUSIONS: Use of the vascular surgery outpatient telehealth evaluation appeared to improve medical visit completion in our region with apparent sociodemographic disparities. Further studies are needed to confirm whether telemedicine expansion has improved access to care in other geographic areas. by the Society for Vascular Surgery. Published by Elsevier Inc. 2023-04 2022-11-12 /pmc/articles/PMC9652098/ /pubmed/36375724 http://dx.doi.org/10.1016/j.jvs.2022.11.039 Text en © 2022 by the Society for Vascular Surgery. Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Practice Management Abou Ali, Adham N. Abdul Malak, Othman M. Hafeez, Muhammad Saad Habib, Salim Cherfan, Patrick Salem, Karim M. Hager, Eric Avgerinos, Efthymios Sridharan, Natalie Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title | Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title_full | Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title_fullStr | Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title_full_unstemmed | Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title_short | Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
title_sort | improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations |
topic | Practice Management |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652098/ https://www.ncbi.nlm.nih.gov/pubmed/36375724 http://dx.doi.org/10.1016/j.jvs.2022.11.039 |
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