Hispanic Patients Used Virtual Care Less After COVID-19 Diagnosis

A study published in BMC Health Services found that Hispanic and Latino individuals are significantly less likely to use, and therefore benefit from, virtual primary care as compared to White populations.

The study consisted of 11,326 participants diagnosed with COVID-19 between March and July 2020. Of this population, 41.7 percent were Hispanic/Latino. Most of the remaining people were non-Hispanic White individuals. Of the entire population, more than half lived in socially vulnerable areas.

Researchers used EHR and Centers for Disease Control and Prevention data to create a cohort design for the study.

Researchers found that virtual primary care increased significantly between the pre- and mid-COVID-19 periods, rising from 3.6 percent to 10.3 percent. However, in-person primary care remained relatively stable, dropping only slightly from 21 percent to 20.7 percent.

Researchers also noticed differences in the use of virtual care among various populations. Hispanic/Latino patients were significantly less likely to use virtual care before or after being diagnosed with COVID-19, compared with White patients.

However, during the study period non-Hispanic Black individuals were more likely to use virtual primary care than non-Hispanic White people.

While social vulnerability measures did not appear to impact virtual primary care use, individuals living in areas characterized as vulnerable based on minority status, language, housing type, and transportation were less likely to use in-person primary care than people living in areas not characterized as vulnerable in these ways.

The study had several limitations, including the omission of various US regions for data, the potential skew in data from COVID-19 patients of multiple populations, and the gaps in EHR data.

But, despite these limitations, researchers concluded that the expansion of virtual care amplified disparities in care access, as specific individuals had less access to certain necessary resources.

Further, a focus on broader outreach is necessary for the future, as this type of approach would expand the benefits of virtual care to underserved populations, according to the researchers.

This data joins growing evidence that racial disparities persist in virtual care. 

For example, a recent study found that telehealth use during the COVID-19 pandemic was inconsistent among various racial groups, primarily due to the digital divide. The study explains that African Americans and Hispanics were 35 percent and 51 percent less likely to use telehealth compared to White people.

As virtual care became increasingly popular during the COVID-19 pandemic, lawmakers and providers attempted to ensure equity in care access.

In April 2020, the Governor of Connecticut, Ned Lamont, signed an executive order that allowed providers to treat Medicaid patients through phone calls. The incentive for this was the rising number of COVID-19 cases and the large proportion of low-income people who were not receiving adequate care.

During the same month, Stanford Medicine launched a program that aimed to establish whether mHealth wearables could assist underserved populations in maintaining cardiovascular health. The project was a subset of a $14 million grant involving the American Hospital Association, Stanford Medicine, Johns Hopkins University, the University of Michigan, and Cincinnati Children’s Hospital, which aimed to reduce healthcare disparities with new technology.