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Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic

INTRODUCTION: Limited data exist regarding demographic-specific teledermatology (TD) utilization during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine TD utilization trends during the pandemic. METHODS: A retrospective cohort study for national and institutional popu...

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Autores principales: Patel, Akash D., Rundle, Chandler W., Liu, Beiyu, Green, Cynthia L., Bailey-Burke, Christian L., Kheterpal, Meenal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906596/
https://www.ncbi.nlm.nih.gov/pubmed/36752961
http://dx.doi.org/10.1007/s13555-023-00900-8
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author Patel, Akash D.
Rundle, Chandler W.
Liu, Beiyu
Green, Cynthia L.
Bailey-Burke, Christian L.
Kheterpal, Meenal
author_facet Patel, Akash D.
Rundle, Chandler W.
Liu, Beiyu
Green, Cynthia L.
Bailey-Burke, Christian L.
Kheterpal, Meenal
author_sort Patel, Akash D.
collection PubMed
description INTRODUCTION: Limited data exist regarding demographic-specific teledermatology (TD) utilization during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine TD utilization trends during the pandemic. METHODS: A retrospective cohort study for national and institutional populations was conducted. Patient encounters in the American Academy of Dermatology’s DataDerm registry (DataDerm) were analyzed from 1 April 2020 through 30 June 2021. All dermatological patients seen by Duke University Health Systems (DUHS) were analyzed from 1 March 2020 through 30 April 2021. In-person clinic visits versus TD encounters (national and institutional) and no-show rates (institutional only) were collected for visit type (i.e., TD versus in-person), sex, race, age/generation, and in- versus out-of-state location (national only). TD utilization is defined as the cohort of interest using TD (e.g., females, whites) within a demographic group (i.e., sex, race) as a percentage of total TD users. This was compared with in-person utilization during the identical timeframe. RESULTS: For US national data, 13,964,816 encounters were analyzed. Sex, race, age, and location each had a significant association with TD utilization (adjusted p < 0.001). For institutional data, 54,400 encounters were analyzed. Sex, race, and age had a significant association with TD utilization (adjusted p < 0.001). Both datasets revealed majority female populations for telehealth visits (DataDerm 66.0%; DUHS 61.7%). Non-white populations accounted for a higher percentage of TD utilizers (DataDerm 15.0%; DUHS 37.3%) when compared with in-person utilizers (DataDerm 11.7%; DUHS 22.3%). Younger patients utilized TD (DataDerm 63.6%; DUHS 62.6%) more than in-person services (DataDerm 26.3%; DUHS 43.8%). Institutional no-show rates between telehealth and in-person visits were lower for Black patients (11.8% versus 19.2%), other non-white races (10.6% versus 13.6%), and younger ages/generations (9.8% versus 12.8%), respectively. TD utilization decreased over time nationally as a percentage of total visits (2.9% versus 0.3%) in 2020 versus 2021, respectively. CONCLUSIONS AND RELEVANCE: During the COVID-19 pandemic, certain populations (females, younger patients, non-white races) showed higher TD utilization. Understanding TD utilization trends is critical in defining the role of virtual care for improving universal care access, optimizing resources, and informing future healthcare models for all patient populations.
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spelling pubmed-99065962023-02-08 Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic Patel, Akash D. Rundle, Chandler W. Liu, Beiyu Green, Cynthia L. Bailey-Burke, Christian L. Kheterpal, Meenal Dermatol Ther (Heidelb) Original Research INTRODUCTION: Limited data exist regarding demographic-specific teledermatology (TD) utilization during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine TD utilization trends during the pandemic. METHODS: A retrospective cohort study for national and institutional populations was conducted. Patient encounters in the American Academy of Dermatology’s DataDerm registry (DataDerm) were analyzed from 1 April 2020 through 30 June 2021. All dermatological patients seen by Duke University Health Systems (DUHS) were analyzed from 1 March 2020 through 30 April 2021. In-person clinic visits versus TD encounters (national and institutional) and no-show rates (institutional only) were collected for visit type (i.e., TD versus in-person), sex, race, age/generation, and in- versus out-of-state location (national only). TD utilization is defined as the cohort of interest using TD (e.g., females, whites) within a demographic group (i.e., sex, race) as a percentage of total TD users. This was compared with in-person utilization during the identical timeframe. RESULTS: For US national data, 13,964,816 encounters were analyzed. Sex, race, age, and location each had a significant association with TD utilization (adjusted p < 0.001). For institutional data, 54,400 encounters were analyzed. Sex, race, and age had a significant association with TD utilization (adjusted p < 0.001). Both datasets revealed majority female populations for telehealth visits (DataDerm 66.0%; DUHS 61.7%). Non-white populations accounted for a higher percentage of TD utilizers (DataDerm 15.0%; DUHS 37.3%) when compared with in-person utilizers (DataDerm 11.7%; DUHS 22.3%). Younger patients utilized TD (DataDerm 63.6%; DUHS 62.6%) more than in-person services (DataDerm 26.3%; DUHS 43.8%). Institutional no-show rates between telehealth and in-person visits were lower for Black patients (11.8% versus 19.2%), other non-white races (10.6% versus 13.6%), and younger ages/generations (9.8% versus 12.8%), respectively. TD utilization decreased over time nationally as a percentage of total visits (2.9% versus 0.3%) in 2020 versus 2021, respectively. CONCLUSIONS AND RELEVANCE: During the COVID-19 pandemic, certain populations (females, younger patients, non-white races) showed higher TD utilization. Understanding TD utilization trends is critical in defining the role of virtual care for improving universal care access, optimizing resources, and informing future healthcare models for all patient populations. Springer Healthcare 2023-02-08 /pmc/articles/PMC9906596/ /pubmed/36752961 http://dx.doi.org/10.1007/s13555-023-00900-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Patel, Akash D.
Rundle, Chandler W.
Liu, Beiyu
Green, Cynthia L.
Bailey-Burke, Christian L.
Kheterpal, Meenal
Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title_full Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title_fullStr Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title_full_unstemmed Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title_short Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic
title_sort teledermatology may benefit marginalized populations: national and institutional trends during the covid-19 pandemic
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906596/
https://www.ncbi.nlm.nih.gov/pubmed/36752961
http://dx.doi.org/10.1007/s13555-023-00900-8
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