Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic.

Abstract

Introduction: Telemedicine expansion during the coronavirus pandemic improved health care access for some. However, studies show disparate uptake among marginalized communities, where minority patients experience higher infection rates. We examined changes in pediatric telemedicine utilization as related to social determinants of health and characteristics of families accessing care. Materials and Methods: This IRB-approved study is a retrospective, cross-sectional comparison of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between January to May 2019 and January to May 2020. Patient and visit characteristics were evaluated by region (Florida or Delaware Valley) and year for age, race, gender, ethnicity, zip code, language, median household income, insurance type, and patient draw. Results: Outcomes varied by region. Pediatric patient visits jumped by 172% in 2020 from the year prior. In Florida, the proportion of Hispanic patients utilizing telemedicine increased, as did patients utilizing government-supported health insurance during the pandemic (ps < 0.05). Practically meaningful, although nonsignificant increases in patient language diversity were found across years in both regions (ps > 0.05). Rural patient utilization remained low (2-5%; ps > 0.05). Discussion: Changes in telemedicine use were observed among pediatric patients in vulnerable populations during the coronavirus disease 2019 (COVID-19) pandemic. Despite increased utilization among Hispanic and low-income families, access to virtual care remains a challenge among patients residing in rural locales. Conclusion: Researchers, health care providers, and policymakers should examine the implementation of varying mitigation strategies that support equal access and use of virtual health care among an increasingly diverse, post-COVID-19 pediatric patient population.