Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study
BackgroundSince the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community o...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2024-12-01
|
| Series: | JMIR Pediatrics and Parenting |
| Online Access: | https://pediatrics.jmir.org/2024/1/e57702 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850114397869965312 |
|---|---|
| author | Priya R Pathak Melissa S Stockwell Mariellen M Lane Laura Robbins-Milne Suzanne Friedman Kalpana Pethe Margaret C Krause Karen Soren Luz Adriana Matiz Lauren B Solomon Maria E Burke Edith Bracho-Sanchez |
| author_facet | Priya R Pathak Melissa S Stockwell Mariellen M Lane Laura Robbins-Milne Suzanne Friedman Kalpana Pethe Margaret C Krause Karen Soren Luz Adriana Matiz Lauren B Solomon Maria E Burke Edith Bracho-Sanchez |
| author_sort | Priya R Pathak |
| collection | DOAJ |
| description |
BackgroundSince the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community over a sustained period has yet to be described.
ObjectiveWe aimed to assess the relationship between demographics, patient portal activation, and telemedicine visits, as well as characterize diagnoses addressed in telemedicine, in a low-income, primarily Latino population over time.
MethodsA multidisciplinary team conducted outreach for telemedicine and patient portal activation with the adoption of a new electronic health record. Data were collected on all in-person and telemedicine visits from February 2020 through April 2021 for 4 community-based pediatric practices. The outcomes included patient portal activation, telemedicine use, and reason for telemedicine visits. Bivariate tests and multivariate regression analyses were conducted to assess the independent effects of demographics on the likelihood of portal activation and having a telemedicine visit. Telemedicine diagnoses were categorized, and subanalyses were conducted to explore variations by age and month.
ResultsThere were 12,377 unique patients and 7127 telemedicine visits. Latino patients made up 83.4% (n=8959) of the population. Nearly all patients (n=10,830, 87.5%) had an activated portal, and 33.8% (n=4169) had at least 1 telemedicine visit. Portal activation decreased with age >2 years (2-4 years: adjusted odds ratio [aOR] 0.62, 95% CI 0.51-0.76; 5-11 years: aOR 0.28, 95% CI 0.23-0.32; 12-14 years: aOR 0.29, 95% CI 0.23-0.35; and 15-17 years: aOR 0.46, 95% CI 0.36-0.58). Spanish-speaking (aOR 0.52, 95% CI 0.45-0.59) and non-Latino patients (aOR 0.64, 95% CI 0.54-0.76) had decreased odds of activation and having a telemedicine visit (aOR 0.81, 95% CI 0.74-0.89 and aOR 0.71, 95% CI 0.62-0.81, respectively). The top 5 diagnostic categories for telemedicine were infectious disease (n=1749, 26.1%), dermatology (n=1287, 19.5%), gastrointestinal (n=771, 11.7%), well and follow-up care (n=459, 7%), and other specialty-related care (n=415, 6.3%). Infectious disease showed the most variation over time. Age-based patterns included a decrease in the proportion of infectious disease diagnoses by increasing age group and a higher proportion of well and follow-up care in older ages. Additional telemedicine diagnoses included common infant concerns for patients younger than 2 years of age; pulmonary, asthma, and allergy concerns for toddler or school-age children; behavioral health concerns for younger adolescents; and genitourinary and gynecologic concerns for older adolescents.
ConclusionsThe high engagement across demographics suggests feasibility and interest in telemedicine in this low-income, primarily Latino population, which may be attributable to the strength of outreach. Language-based disparities were still present. Telemedicine was used for a wide range of diagnoses. As telemedicine remains a vital component of pediatric health care, targeted interventions may enhance engagement to serve diverse pediatric patient populations. |
| format | Article |
| id | doaj-art-14cee321dcc64798b17e6ecb9b803d93 |
| institution | OA Journals |
| issn | 2561-6722 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Pediatrics and Parenting |
| spelling | doaj-art-14cee321dcc64798b17e6ecb9b803d932025-08-20T02:36:53ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222024-12-017e5770210.2196/57702Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective StudyPriya R Pathakhttps://orcid.org/0000-0002-1157-5550Melissa S Stockwellhttps://orcid.org/0000-0002-2113-7247Mariellen M Lanehttps://orcid.org/0000-0002-3516-2582Laura Robbins-Milnehttps://orcid.org/0000-0002-6328-7606Suzanne Friedmanhttps://orcid.org/0000-0001-5537-3881Kalpana Pethehttps://orcid.org/0000-0001-5318-1886Margaret C Krausehttps://orcid.org/0009-0007-9826-6796Karen Sorenhttps://orcid.org/0000-0003-2702-8145Luz Adriana Matizhttps://orcid.org/0000-0003-2932-1337Lauren B Solomonhttps://orcid.org/0009-0005-3318-1359Maria E Burkehttps://orcid.org/0009-0007-1499-1836Edith Bracho-Sanchezhttps://orcid.org/0000-0001-8251-714X BackgroundSince the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community over a sustained period has yet to be described. ObjectiveWe aimed to assess the relationship between demographics, patient portal activation, and telemedicine visits, as well as characterize diagnoses addressed in telemedicine, in a low-income, primarily Latino population over time. MethodsA multidisciplinary team conducted outreach for telemedicine and patient portal activation with the adoption of a new electronic health record. Data were collected on all in-person and telemedicine visits from February 2020 through April 2021 for 4 community-based pediatric practices. The outcomes included patient portal activation, telemedicine use, and reason for telemedicine visits. Bivariate tests and multivariate regression analyses were conducted to assess the independent effects of demographics on the likelihood of portal activation and having a telemedicine visit. Telemedicine diagnoses were categorized, and subanalyses were conducted to explore variations by age and month. ResultsThere were 12,377 unique patients and 7127 telemedicine visits. Latino patients made up 83.4% (n=8959) of the population. Nearly all patients (n=10,830, 87.5%) had an activated portal, and 33.8% (n=4169) had at least 1 telemedicine visit. Portal activation decreased with age >2 years (2-4 years: adjusted odds ratio [aOR] 0.62, 95% CI 0.51-0.76; 5-11 years: aOR 0.28, 95% CI 0.23-0.32; 12-14 years: aOR 0.29, 95% CI 0.23-0.35; and 15-17 years: aOR 0.46, 95% CI 0.36-0.58). Spanish-speaking (aOR 0.52, 95% CI 0.45-0.59) and non-Latino patients (aOR 0.64, 95% CI 0.54-0.76) had decreased odds of activation and having a telemedicine visit (aOR 0.81, 95% CI 0.74-0.89 and aOR 0.71, 95% CI 0.62-0.81, respectively). The top 5 diagnostic categories for telemedicine were infectious disease (n=1749, 26.1%), dermatology (n=1287, 19.5%), gastrointestinal (n=771, 11.7%), well and follow-up care (n=459, 7%), and other specialty-related care (n=415, 6.3%). Infectious disease showed the most variation over time. Age-based patterns included a decrease in the proportion of infectious disease diagnoses by increasing age group and a higher proportion of well and follow-up care in older ages. Additional telemedicine diagnoses included common infant concerns for patients younger than 2 years of age; pulmonary, asthma, and allergy concerns for toddler or school-age children; behavioral health concerns for younger adolescents; and genitourinary and gynecologic concerns for older adolescents. ConclusionsThe high engagement across demographics suggests feasibility and interest in telemedicine in this low-income, primarily Latino population, which may be attributable to the strength of outreach. Language-based disparities were still present. Telemedicine was used for a wide range of diagnoses. As telemedicine remains a vital component of pediatric health care, targeted interventions may enhance engagement to serve diverse pediatric patient populations.https://pediatrics.jmir.org/2024/1/e57702 |
| spellingShingle | Priya R Pathak Melissa S Stockwell Mariellen M Lane Laura Robbins-Milne Suzanne Friedman Kalpana Pethe Margaret C Krause Karen Soren Luz Adriana Matiz Lauren B Solomon Maria E Burke Edith Bracho-Sanchez Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study JMIR Pediatrics and Parenting |
| title | Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study |
| title_full | Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study |
| title_fullStr | Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study |
| title_full_unstemmed | Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study |
| title_short | Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study |
| title_sort | access to primary care telemedicine and visit characterization in a pediatric low income primarily latino population retrospective study |
| url | https://pediatrics.jmir.org/2024/1/e57702 |
| work_keys_str_mv | AT priyarpathak accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT melissasstockwell accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT mariellenmlane accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT laurarobbinsmilne accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT suzannefriedman accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT kalpanapethe accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT margaretckrause accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT karensoren accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT luzadrianamatiz accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT laurenbsolomon accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT mariaeburke accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy AT edithbrachosanchez accesstoprimarycaretelemedicineandvisitcharacterizationinapediatriclowincomeprimarilylatinopopulationretrospectivestudy |