Equal Access to Telemedicine during COVID-19 Pandemic: A Pediatric Otolaryngology Perspective

Laryngoscope. 2020 Sep 24. doi: 10.1002/lary.29164. Online ahead of print.


OBJECTIVES: During the current COVID-19 pandemic, the demand for direct-to-home telemedicine services has risen to an unprecedented level. Equal access to specialty care was assessed to identify potential barriers that may negatively impact telemedicine utilization.

METHODS: We examined the 6-week period between March and May 2020 when the only access to non-urgent pediatric otolaryngology service was through telemedicine and compared it to in-person visits during the same period in 2019. We compared patient demographics including age, gender, preferred language, zip code of residence and primary insurance plan.

RESULTS: A total of 1495 visits were conducted through telemedicine from 3/23/2020 to 5/1/2020, and 1983 in-person visits were completed in 2019. There was no difference in patient age and gender. The proportions of Spanish speaking families were similar (15.8% in 2019 vs. 14.4% in 2020, p=0.96). The percentage of Medi-Cal insured patients (51.4% in 2019 vs.49.8% in 2020, p=0.73) and the mean poverty level (12.6% in 2019 vs. 12.2% in 2020, p=0.38) also remained the same. Spanish speaking families were statistically more likely to require rescheduling of their telemedicine visits (17.2%) when compared to the overall rescheduling rate of 11.9% (p=0.0083).

CONCLUSIONS: We were able to successfully provide access to telemedicine services to our vulnerable populations during the current COVID-19 pandemic. Telemedicine is likely to remain an essential mode of delivering patient care going forward. It is important to evaluate and identify potential disparities to telemedicine access and proactively implement changes to address these barriers. This article is protected by copyright. All rights reserved.

PMID:32969043 | DOI:10.1002/lary.29164