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Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA

Low-income populations are at higher risk of missing appointments, resulting in fragmented care and worsening disparities. Compared to face-to-face encounters, telehealth visits are more convenient and could improve access for low-income populations. All outpatient encounters at the Parkland Health...

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Autores principales: Sumarsono, Andrew, Case, Molly, Kassa, Sentayehu, Moran, Brett
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994401/
https://www.ncbi.nlm.nih.gov/pubmed/36884183
http://dx.doi.org/10.1007/s11524-023-00721-2
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author Sumarsono, Andrew
Case, Molly
Kassa, Sentayehu
Moran, Brett
author_facet Sumarsono, Andrew
Case, Molly
Kassa, Sentayehu
Moran, Brett
author_sort Sumarsono, Andrew
collection PubMed
description Low-income populations are at higher risk of missing appointments, resulting in fragmented care and worsening disparities. Compared to face-to-face encounters, telehealth visits are more convenient and could improve access for low-income populations. All outpatient encounters at the Parkland Health between March 2020 and June 2022 were included. No-show rates were compared across encounter types (face-to-face vs telehealth). Generalized estimating equations were used to evaluate the association of encounter type and no-show encounters, clustering by individual patient and adjusting for demographics, comorbidities, and social vulnerability. Interaction analyses were performed. There were 355,976 unique patients with 2,639,284 scheduled outpatient encounters included in this dataset. 59.9% of patients were of Hispanic ethnicity, while 27.0% were of Black race. In a fully adjusted model, telehealth visits were associated with a 29% reduction in odds of no-show (aOR 0.71, 95% CI: 0.70–0.72). Telehealth visits were associated with significantly greater reductions in probability of no-show among patients of Black race and among those who resided in the most socially vulnerable areas. Telehealth encounters were more effective in reducing no-shows in primary care and internal medicine subspecialties than surgical specialties or other non-surgical specialties. These data suggest that telehealth may serve as a tool to improve access to care in socially complex patient populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11524-023-00721-2.
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spelling pubmed-99944012023-03-09 Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA Sumarsono, Andrew Case, Molly Kassa, Sentayehu Moran, Brett J Urban Health Original Article Low-income populations are at higher risk of missing appointments, resulting in fragmented care and worsening disparities. Compared to face-to-face encounters, telehealth visits are more convenient and could improve access for low-income populations. All outpatient encounters at the Parkland Health between March 2020 and June 2022 were included. No-show rates were compared across encounter types (face-to-face vs telehealth). Generalized estimating equations were used to evaluate the association of encounter type and no-show encounters, clustering by individual patient and adjusting for demographics, comorbidities, and social vulnerability. Interaction analyses were performed. There were 355,976 unique patients with 2,639,284 scheduled outpatient encounters included in this dataset. 59.9% of patients were of Hispanic ethnicity, while 27.0% were of Black race. In a fully adjusted model, telehealth visits were associated with a 29% reduction in odds of no-show (aOR 0.71, 95% CI: 0.70–0.72). Telehealth visits were associated with significantly greater reductions in probability of no-show among patients of Black race and among those who resided in the most socially vulnerable areas. Telehealth encounters were more effective in reducing no-shows in primary care and internal medicine subspecialties than surgical specialties or other non-surgical specialties. These data suggest that telehealth may serve as a tool to improve access to care in socially complex patient populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11524-023-00721-2. Springer US 2023-03-08 2023-04 /pmc/articles/PMC9994401/ /pubmed/36884183 http://dx.doi.org/10.1007/s11524-023-00721-2 Text en © The New York Academy of Medicine 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
spellingShingle Original Article
Sumarsono, Andrew
Case, Molly
Kassa, Sentayehu
Moran, Brett
Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title_full Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title_fullStr Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title_full_unstemmed Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title_short Telehealth as a Tool to Improve Access and Reduce No-Show Rates in a Large Safety-Net Population in the USA
title_sort telehealth as a tool to improve access and reduce no-show rates in a large safety-net population in the usa
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994401/
https://www.ncbi.nlm.nih.gov/pubmed/36884183
http://dx.doi.org/10.1007/s11524-023-00721-2
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