Does Language Proficiency Affect Completion of Telerehabilitation Video Visits? A Retrospective Study.

Abstract

Telehealth use increased dramatically after the COVID-19 pandemic enabled largely by regulatory changes. Health policy experts recommend telehealth as a viable option for healthcare delivery in the post-pandemic world. As investment in telehealth continues, it is important to ensure that existing health disparities are not exacerbated. One group that is particularly vulnerable to telehealth challenges includes patients with limited English Proficiency. This study aimed to examine whether English proficiency is associated with completion of telerehabilitation visits. Electronic Health Records were retrieved for all patients scheduled for a telerehabilitation visit (physical/occupational therapy) in adult or pediatric outpatient clinics at a large academic medical center between April 1, 2020 and April 30, 2022. Using data from 3,871 video visits involving 1414 patients, binomial logistic regression models were estimated to examine associations between sociodemographic variables (age, gender, race, ethnicity, insurance status, income, language preference) and visit completion rate using multivariable logistic regression models. 6.4% of telerehabilitation visits were conducted in a language other than English. 24% patients had a 0% completion rate, 9% had a completion rate of > 0% and < 100%, and 67% had a 100% completion rate. Being older and publicly insured was significantly associated with decreased odds of 100% completion. Patients with English as their preferred language showed higher odds of visit completion. Age, type of insurance, and language preference were associated with successful completion of telerehabilitation video visits. Future research is needed to reveal specific barriers to telerehabilitation for older patients and those with limited English proficiency.