Patient Characteristics and Telemedicine Use in the US, 2022

• Published in: JAMA network open 2024-03, Vol.7 (3), p.e243354
• Main Authors: Chang, Eva, Penfold, Robert B, Berkman, Nancy D
• Format: Article
• Language: English
• Subjects: Adult; Correlation of Data; COVID-19 - epidemiology; Cross-Sectional Studies; Female; Health care access; Humans; Male; Middle Aged; Pandemics; Patients; Telemedicine
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2024.3354

Telemedicine use was common during the COVID-19 pandemic, expanding many patients' approaches to accessing health care. Of concern is whether telemedicine access was poorer among higher-needs and disadvantaged populations. To assess patient characteristics associated with telemedicine use and telemedicine mode and describe telemedicine visit experiences by telemedicine mode. This cross-sectional study included data from the 2022 Health Information National Trends Survey and included US adults with a health care visit. Data were analyzed from May to September 2023. Patient characteristics. Any telemedicine visits vs in-person visits only; telemedicine mode (video vs audio-only). Multivariable logistic models assessed patient characteristics associated with telemedicine visits and mode. Bivariate analyses compared telemedicine experiences by mode. The study included 5437 adult patients (mean [SE] age, 49.4 [0.23] years; 3136 females [53.4%]; 1928 males [46.6%]). In 2022, 2384 patients (43%) had a telemedicine visit; 1565 (70%) had a video visit while 819 (30%) had an audio-only visit. In multivariable models, older age (≥75 years: adjusted odds ratio [aOR], 0.63; 95% CI, 0.42-0.94), no internet use (aOR, 0.62; 95% CI, 0.48-0.81), and living in the Midwest (aOR, 0.50; 95% CI, 0.35-0.70) were negatively associated with having telemedicine visits. Female sex (aOR, 1.43; 95% CI, 1.12-1.83), having chronic conditions (aOR, 2.13; 95% CI, 1.66-2.73), and multiple health care visits (2-4 visits: aOR, 1.77; 95% CI, 1.23-2.54; ≥5 visits: aOR, 3.29; 95% CI, 2.20-4.92) were positively associated. Among individuals who used telemedicine, older age (65-74 years: aOR, 2.13; 95% CI, 1.09-4.14; ≥75 years: aOR, 3.58; 95% CI, 1.60-8.00), no health insurance (aOR, 2.84; 95% CI, 1.42-5.67), and no internet use (aOR, 2.11; 95% CI, 1.18-3.78) were positively associated with having audio-only visits. We observed no significant differences in telemedicine use or mode by education, race and ethnicity, or income. Patients' experiences using telemedicine were generally similar for video and audio-only except more individuals who used audio-only had privacy concerns (20% vs 12%, P = .02). In this cross-sectional study of adults with health care visits, many patients, including those with the greatest care needs, chose telemedicine even after in-person visits were available. These findings support continuing this care delivery approach as an option valued by patients. Differences were no