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Primary Care Appointment Completion Rates and Telemedicine Utilization Among Black and Non-Black Patients from 2019 to 2020.
Anastos-Wallen, Rebecca E; Mitra, Nandita; Coburn, Brian W; Shultz, Kaitlyn; Rhodes, Corinne; Snider, Christopher; Eberly, Lauren; Adusumalli, Srinath; Chaiyachati, Krisda H.
Afiliación
  • Anastos-Wallen RE; Department of Medicine and Epidemiology, and Informatics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Mitra N; Oak Street Health, Philadelphia, Pennsylvania, USA.
  • Coburn BW; Department of Biostatistics, Epidemiology, and Informatics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Shultz K; Department of Medicine and Epidemiology, and Informatics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Rhodes C; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Snider C; Division of General Internal Medicine, Department of Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Eberly L; Department of Medicine and Epidemiology, and Informatics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Adusumalli S; Division of General Internal Medicine, Department of Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Chaiyachati KH; Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA.
Telemed J E Health ; 28(12): 1786-1795, 2022 12.
Article en En | MEDLINE | ID: mdl-35501950
Objective: To understand how differences in primary care appointment completion rates between Black and non-Black patients changed in 2020 within the context of the COVID-19 pandemic and when telemedicine utilization peaked. Materials and Methods: We conducted a retrospective cohort study using the electronic health record from January 1 to December 31, 2020, among all adults scheduled for a primary care appointment within a large academic medical center. We used mixed-effects logistic regression to estimate adjusted appointment completion rates for Black patients compared with those for non-Black patients in 2020 as compared with those in 2019 within four time periods: (1) prepandemic (January 1, 2020, to March 12, 2020), (2) shutdown (March 13, 2020, to June 3, 2020), (3) reopening (June 4, 2020, to September 30, 2020), and (4) second wave (October 1, 2020, to December 31, 2020). Results: Across 1,947,399 appointments, differences in appointment completion rates between Black and non-Black patients improved in all time periods: +1.4 percentage points prepandemic (95% confidence interval [CI]: +0.8 to +2.0), +11.7 percentage points during shutdown (95% CI: +11.0 to +12.3), +8.2 percentage points during reopening (95% CI: +7.8 to +8.7), and +7.1 percentage points during second wave (95% CI: +6.4 to +7.8) (all p-values <0.001). The types of conditions managed by primary care shifted during the shutdown period, but the remainder of 2020 mirrored those from 2019. Discussion: Racial differences in appointment completion rates narrowed significantly in 2020 even as the mix of disease conditions began to mirror patterns observed in 2019. Conclusions and Relevance: Telemedicine may be an important tool for improving access to primary care for Black patients. These findings should be key considerations as regulators and payors determine telemedicine's future.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / COVID-19 Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Telemed J E Health Asunto de la revista: INFORMATICA MEDICA / SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / COVID-19 Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Telemed J E Health Asunto de la revista: INFORMATICA MEDICA / SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos