Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Mika M Rockholt,1 Gifty Addae,1 Alexander Chee,1 Wanda Chin,1 Germaine Cuff,1 Jing Wang,1,2 Uchenna O Umeh,1,3 Lisa V Doan1 1Department of Anesthesiology, Perioperative Care and Pain Management, New York University Grossman School of Medicine, New York, NY, 10016, USA; 2Department of Neuroscience &a...

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Main Authors: Rockholt MM, Addae G, Chee A, Chin W, Cuff G, Wang J, Umeh UO, Doan LV
Format: Article
Language:English
Published: Dove Medical Press 2023-08-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/implementing-telemedicine-during-the-covid-19-pandemic-disparities-in--peer-reviewed-fulltext-article-JPR
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author Rockholt MM
Addae G
Chee A
Chin W
Cuff G
Wang J
Umeh UO
Doan LV
author_facet Rockholt MM
Addae G
Chee A
Chin W
Cuff G
Wang J
Umeh UO
Doan LV
author_sort Rockholt MM
collection DOAJ
description Mika M Rockholt,1 Gifty Addae,1 Alexander Chee,1 Wanda Chin,1 Germaine Cuff,1 Jing Wang,1,2 Uchenna O Umeh,1,3 Lisa V Doan1 1Department of Anesthesiology, Perioperative Care and Pain Management, New York University Grossman School of Medicine, New York, NY, 10016, USA; 2Department of Neuroscience & Physiology, Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA; 3Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York, NY, 10016, USACorrespondence: Mika M Rockholt, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA, Tel +1 646-209-7590, Email Mika.Rockholt@nyulangone.orgPurpose: The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.Patients and methods: All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) – were analyzed and compared.Results: In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p < 0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p < 0.05).Conclusion: We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.Keywords: telemedicine, pain medicine, health care access, covid-19, disparities
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spelling doaj.art-19d9b1c5461344f7ac9cbe9971dae4d82023-08-08T19:52:16ZengDove Medical PressJournal of Pain Research1178-70902023-08-01Volume 162763277585760Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine PracticeRockholt MMAddae GChee AChin WCuff GWang JUmeh UODoan LVMika M Rockholt,1 Gifty Addae,1 Alexander Chee,1 Wanda Chin,1 Germaine Cuff,1 Jing Wang,1,2 Uchenna O Umeh,1,3 Lisa V Doan1 1Department of Anesthesiology, Perioperative Care and Pain Management, New York University Grossman School of Medicine, New York, NY, 10016, USA; 2Department of Neuroscience & Physiology, Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA; 3Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York, NY, 10016, USACorrespondence: Mika M Rockholt, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA, Tel +1 646-209-7590, Email Mika.Rockholt@nyulangone.orgPurpose: The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.Patients and methods: All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) – were analyzed and compared.Results: In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p < 0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p < 0.05).Conclusion: We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.Keywords: telemedicine, pain medicine, health care access, covid-19, disparitieshttps://www.dovepress.com/implementing-telemedicine-during-the-covid-19-pandemic-disparities-in--peer-reviewed-fulltext-article-JPRtelemedicinepain medicinehealth care accesscovid-19disparities
spellingShingle Rockholt MM
Addae G
Chee A
Chin W
Cuff G
Wang J
Umeh UO
Doan LV
Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
Journal of Pain Research
telemedicine
pain medicine
health care access
covid-19
disparities
title Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
title_full Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
title_fullStr Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
title_full_unstemmed Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
title_short Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice
title_sort implementing telemedicine during the covid 19 pandemic disparities in utilization in an urban pain medicine practice
topic telemedicine
pain medicine
health care access
covid-19
disparities
url https://www.dovepress.com/implementing-telemedicine-during-the-covid-19-pandemic-disparities-in--peer-reviewed-fulltext-article-JPR
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