Old age, non-English language tied to incomplete telehealth visit

Older patients, non‒English-speaking individuals, and ethnic/racial minorities are less likely to complete a video telemedicine encounter for ophthalmic care during the COVID-19 pandemic, a study has found.

A total of 5,023 patients comprising 8,116 ophthalmic clinical encounters were analysed in this cross-sectional study in an academic ophthalmology centre from March 2020 through August 2020. The authors abstracted medical charts for demographic information. They also identified zip code-level socioeconomic characteristics drawn from the 2019 American Community Survey 5-year estimates.

Of the patients, 446 (8.9 percent) participated in a video encounter, 642 (12.8 percent) completed a telephone encounter, and 3,935 (78.3 percent) attended clinical appointments in person only.

Adjusted analysis revealed that patients who were Black (odds ratio [OR], 0.65, 95 percent confidence interval [CI], 0.52‒0.80; p<0.001) or Hispanic/Latino (OR, 0.65, 95 percent CI, 0.49‒0.85; p=0.002) were more likely to have an incomplete video or telephone appointment.

Older patients (OR, 0.99, 95 percent CI, 0.98‒0.99; p<0.001), those whose primary language was not English (OR, 0.49, 95 percent CI, 0.28‒0.82; p=0.01), Blacks (OR, 0.45, 95 percent CI, 0.32‒0.62; p<0.001), Hispanics/Latinos (OR, 0.56, 95 percent CI, 0.37‒0.83; p=0.005) were also significantly less likely to complete a video encounter.

Among patients completing any type of telemedicine encounter, older age (OR, 1.02, 95 percent CI, 1.01‒1.03; p<0.001), Medicare insurance (OR, 1.55, 95 percent CI, 1.11‒2.17; p=0.01), and Black race (OR, 1.97, 95 percent CI, 1.33‒2.94; p<0.001) correlated with using only phone visits.

“With the expansion of telemedicine and the need to reduce the disparate impact of COVID-19 on minorities, it will be increasingly important to identify barriers to telehealth use and opportunities to improve access,” the authors said.