IMPACT AND HEALTHCARE UTILIZATION PATTERNS OF AN ORTHOPEDIC TELEMEDICINE PROGRAM IN BRAZIL.

Abstract

Objective: To examine the relationship between place of residence, social vulnerability, and telemedicine access among orthopedic patients at a tertiary hospital in São Paulo, Brazil.

Methods: A cross-sectional, comparative study analyzing sociodemographic, economic, and geographic characteristics of 475 patients who attended telemedicine consultations between August 2022 and August 2023. Patients were grouped by their Social Vulnerability Index (IVS) to assess differences in travel distances, costs, and accessibility challenges. The analysis included comparisons of demographic factors, financial burdens, and telemedicine's impact on reducing travel constraints.

Results: Telemedicine consultations avoided an average travel distance of 211 km and saved approximately 44 USD per consultation. Patients from higher IVS regions had significantly greater travel distances, longer travel times, lower formal education levels, and were more likely to be younger, male, and of non-White race. Additionally, these patients more frequently reported missing work for in-person visits. Telemedicine access disparities reflect broader socioeconomic and geographic inequalities.

Conclusions: This study highlights how spatial and socioeconomic vulnerabilities shape telemedicine access in Brazil. Travel burdens and job insecurity disproportionately affect vulnerable groups, while social support mitigates barriers for older adults. Level of Evidence III; Cross-Sectional Study.