Telemedicine Use Following Onset of the COVID-19 Pandemic Was Associated With Youth and White Race but Not With Socioeconomic Deprivation: A Retrospective Cohort Study of Orthopedic Patients

Abstract

The use of telemedicine increased greatly following the onset of the COVID-19 pandemic. It is unclear whether and how sociodemographic factors have affected orthopedics patients’ use of this technology in the pandemic. The aim of this study was to determine how patient demographic variability in telemedicine use is influenced by the Area Deprivation Index (ADI) and distance to clinical site among patients seeking care for hip and knee arthritis from orthopedic surgeons. Demographic data and visit type were collected from the electronic medical record for patients seen in our academic medical center either before or during the COVID-19 pandemic by orthopedic surgeons who specialize in hip and knee arthroplasty. Univariate and multivariate analyses were performed regarding age, race, insurance status, ADI, and distance to a clinical site. In the COVID era, among 4901 visits with 3124 unique patients, those using telemedicine were younger and more likely to be White compared to those who did not use telemedicine. There was no significant difference in telemedicine use based on ADI, distance to a clinical site, or insurance status. This retrospective analysis suggests that orthopedic patients who were White and of younger age were more likely to use telemedicine in the first year of the COVID-19 pandemic. There was no statistically significant relationship between distance from a clinical site or ADI and telemedicine use, suggesting that factors other than these are greater contributors to telemedicine utilization in our cohort. Further information is needed to determine how telemedicine may disproportionately limit access to orthopedic care according to these and other patient factors.