Disparities in spatial accessibility of primary care in Louisiana: From physical to virtual accessibility

Telehealth has been widely employed and has transformed how healthcare is delivered in the United States as a result of COVID-19 pandemic. While telehealth is utilized and encouraged to reduce the cost and travel burden for access to healthcare, there are debates on whether telehealth can promote equity in healthcare services by narrowing the gap among diverse groups. Using the Two-Step Floating Catchment Area (2SFCA) and Two-Step Virtual Catchment Area (2SVCA) methods, this study compares the disparities of physical and virtual access to primary care physicians (PCPs) in Louisiana. Both physical and virtual access to PCPs exhibit similar spatial patterns with higher scores concentrated in urban areas, followed by low-density and rural areas. However, the two accessibility measures diverge where broadband availability and affordability come to play an important role. Residents in rural areas experience additive disadvantage of even more limited telehealth accessibility than physical accessibility due to lack of broadband service provision. Areas with greater Black population proportions tend to have better physical accessibility, but such an advantage is eradicated for telehealth accessibility because of lower broadband subscription rates in these neighborhoods. Both physical and virtual accessibility scores decline in neighborhoods with higher Area Deprivation Index (ADI) values, and the disparity is further widened for in virtual accessibility compared to than physical accessibility. The study also examines how factors such as urbanicity, Black population proportion, and ADI interact in their effects on disparities of the two accessibility measures.

Automated summary

Telehealth has been widely adopted in the US during the COVID-19 pandemic, transforming healthcare delivery. There are debates on whether telehealth can promote equity in healthcare services. This study compares the disparities of physical and virtual access to primary care physicians (PCPs) in Louisiana using the Two-Step Floating Catchment Area (2SFCA) and Two-Step Virtual Catchment Area (2SVCA) methods. The findings show that both physical and virtual access to PCPs exhibit similar spatial patterns, with higher scores in urban areas. However, the availability and affordability of broadband play a crucial role, with rural areas experiencing limited telehealth accessibility due to lack of broadband service provision. In neighborhoods with a greater Black population, the advantage in physical accessibility is diminished for telehealth due to lower broadband subscription rates.