4.5 Article

Variation In Telemedicine Use And Outpatient Care During The COVID-19 Pandemic In The United States

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HEALTH AFFAIRS
卷 40, 期 2, 页码 349-358

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PROJECT HOPE
DOI: 10.1377/hlthaff.2020.01786

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资金

  1. National Institute on Aging [K23 AG058806-01]
  2. National Institute of Mental Health [R01 MH112829, T32MH019733]
  3. National Institutes of Health

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During the pandemic, there was a significant increase in the use of telemedicine, but there were notable variations in usage across different populations and specialties. Telemedicine use was lower in communities with higher poverty rates and some medical specialties. Telemedicine was more commonly used for certain common conditions, and its usage for these conditions was associated with smaller decreases in total weekly visits during the pandemic.
Coronavirus disease 2019 (COVID-19) spurred a rapid rise in telemedicine, but it is unclear how use has varied by clinical and patient factors during the pandemic. We examined the variation in total outpatient visits and telemedicine use across patient demographics, specialties, and conditions in a database of 16.7 million commercially insured and Medicare Advantage enrollees from January to June 2020. During the pandemic, 30.1 percent of all visits were provided via telemedicine, and the weekly number of visits increased twenty-three-fold compared with the prepandemic period. Telemedicine use was lower in communities with higher rates of poverty (31.9 percent versus 27.9 percent for the lowest and highest quartiles of poverty rate, respectively). Across specialties, the use of any telemedicine during the pandemic ranged from 68 percent of endocrinologists to 9 percent of ophthalmologists. Across common conditions, the percentage of visits provided during the pandemic via telemedicine ranged from 53 percent for depression to 3 percent for glaucoma. Higher rates of telemedicine use for common conditions were associated with smaller decreases in total weekly visits during the pandemic.

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