Racial and ethnic differences in telemedicine use among community-dwelling older adults with dementia

IF 4.3 2区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of the American Geriatrics Society Pub Date : 2024-06-05 DOI:10.1111/jgs.19039

Qiuyuan Qin MS, Helena Temkin-Greener PhD, Peter Veazie PhD, Shubing Cai PhD

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引用次数: 0

Abstract

Background

Routine ambulatory care is essential for older adults with Alzheimer's disease and related dementias (ADRD) to manage their health conditions. The federal government expanded telemedicine coverage to mitigate the impact of the COVID-19 pandemic on ambulatory services, which may provide an opportunity to improve access to care. This study aims to examine differences in telemedicine use for ambulatory services by race, ethnicity, and community-level socioeconomic status among community-dwelling older adults with ADRD.

Methods

This retrospective cohort study used Medicare claims data between April 01, 2020 and December 31, 2021. We included community-dwelling Medicare fee-for-service beneficiaries aged 65 years and older with ADRD. The outcome variable is individual's use (yes/no) of telemedicine evaluation and management (tele-EM) visits in each quarter. The key independent variables are race, ethnicity, and community-level socioeconomic status.

Results

The analytical sample size of the study was 2,068,937, including 9.9% Black, 82.7% White, and 7.4% Hispanic individuals. In general, we observed a decreasing trend of tele-EM use, and the average rate of quarterly tele-EM use was 23.0%. Tele-EM utilization varied by individual race, ethnicity, and community-level socioeconomic status. On average, White and Black individuals in deprived communities were 3.5 and 2.4 percentage-points less likely to use tele-EM compared with their counterparts in less-deprived communities (p < 0.001). However, Hispanic individuals in deprived communities were 2.4 percentage-points more likely to utilize tele-EM compared with those in less-deprived communities (p < 0.001). Additionally, we observed various racial and ethnic differences in telemedicine use in deprived communities versus less-deprived communities.

Conclusions

We observed various racial and ethnic differences in telemedicine use, both within and between communities by socioeconomic status. Telemedicine is a viable healthcare delivery option that may influence healthcare access for racial and ethnic minorities and for individuals in socioeconomically deprived communities. Further policies or interventions may be needed to ensure all individuals have equal access to newly available care delivery models.

查看原文本刊更多论文

居住在社区的老年痴呆症患者使用远程医疗的种族和民族差异。

背景：对于患有阿尔茨海默病和相关痴呆症（ADRD）的老年人来说，常规门诊护理对于控制其健康状况至关重要。联邦政府扩大了远程医疗的覆盖范围，以减轻 COVID-19 大流行对门诊服务的影响，这可能为改善医疗服务的可及性提供了机会。本研究旨在探讨在社区居住的患有 ADRD 的老年人中，不同种族、族裔和社区社会经济地位的人在使用远程医疗提供非住院服务方面的差异：这项回顾性队列研究使用了 2020 年 4 月 1 日至 2021 年 12 月 31 日期间的医疗保险报销数据。我们纳入了 65 岁及以上患有 ADRD 的社区医疗保险付费服务受益人。结果变量是个人在每个季度对远程医疗评估和管理（tele-EM）访问的使用情况（是/否）。关键的自变量是种族、民族和社区一级的社会经济状况：研究的分析样本量为 2,068,937 人，其中黑人占 9.9%，白人占 82.7%，西班牙裔占 7.4%。总体而言，我们观察到远程急诊室的使用率呈下降趋势，每季度远程急诊室的平均使用率为 23.0%。远程紧急医疗的使用率因个人的种族、民族和社区社会经济地位而异。贫困社区的白人和黑人与不太贫困社区的白人和黑人相比，使用远程紧急医疗的可能性分别平均降低了 3.5 个百分点和 2.4 个百分点（P，结论）：我们观察到，在社会经济地位不同的社区内部和社区之间，远程医疗的使用存在不同的种族和民族差异。远程医疗是一种可行的医疗服务选择，可能会影响少数种族和少数民族以及社会经济贫困社区的个人获得医疗服务的机会。可能需要进一步的政策或干预措施，以确保所有人都能平等地使用新的医疗服务模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Geriatrics Society 医学-老年医学

CiteScore

10.00

自引率

6.30%

发文量

504

审稿时长

3-6 weeks

期刊介绍： Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.