Eating disorder care via telehealth: access and quality of care among adolescents and young adults, 2018-2022.

Abstract

We investigated how the COVID-19 pandemic shift impacted access to and quality of eating disorder (ED) care via telehealth (TH) for adolescents and young adults (AYA), focusing on demographic trends for patients in the pre- and pandemic periods. Retrospective analysis of patients aged 10-26 with ED-related ICD-10 codes at a tertiary care hospital in Northern California was conducted. Using electronic health record data, we compared care access (visit types, missed appointments) and quality (hospital length of stay, readmissions) across pre-pandemic (Feb 2018-Feb 2020) and pandemic (June 2020-June 2022) periods. Outpatient visits increased 29% in the pandemic (n = 740 vs. 575). Hispanic patient representation rose by 59%, while non-Hispanic White and Asian patients decreased. During the pandemic, 531 patients used TH, and 209 were seen in person visits. In-person patients had over twice the odds of missing appointments. No differences were found in hospital length of stay (LOS) or readmission rates between TH and in-person care. TH use increased significantly during the pandemic, improving appointment adherence and access while maintaining care quality. The rise in Hispanic patients and changes in insurance patterns highlight the need for further research into equity and the long-term implications of TH in ED treatment.