Economic Disadvantage Linked to Missed Pediatric Telehealth Appointments
Researchers found that a higher probability of economic disadvantage was associated with a higher rate of missed telehealth appointments for pediatric patients.
A study published in JAMA Pediatrics revealed that economic disadvantages were associated with missed telehealth appointments among pediatric patients during the COVID-19 pandemic.
The study included data from 231,386 visits at a multisite comprehensive pediatric gastroenterology practice. Of these, 183,594 occurred in-person, and 47,792 occurred through telehealth. The in-person group included those who had appointments between March 1, 2016, and Feb. 29, 2020, while the telemedicine group included all virtual appointments from April 1, 2020, to Aug. 1, 2021.
Researchers categorized patients included in the study as having either a higher probability of economic disadvantage (HPED) or a lower probability of economic disadvantage (LPED).
Those defined as having an HPED were covered by public health insurance and lived in the top 25 percent of highest poverty rate zip codes in Massachusetts.
When comparing economic status with the number of missed appointments, researchers also considered factors such as age, sex, distance from the clinic, and income status to determine any correlation.
Researchers determined that those with an HPED had a higher rate of missed appointments overall. They also observed this to be consistent across all races.
Regarding the telehealth group, those with an HPED also had a high no-show rate, which was consistent across all races.
Researchers concluded that socioeconomic status was associated with the number of missed appointments.
However, the study includes certain limitations, mainly relating to the omission of some factors that affect attendance, the lack of confirmation regarding individual socioeconomic statuses, and the lack of acknowledgment of how findings relate to all subspecialties.
"However, as telemedicine continues to shape the clinical encounter landscape, these findings show that efforts are needed to ensure that all patients receive equitable care," the researchers stated.
Previous studies have also indicated that those with lower socioeconomic status often struggle to connect with a provider through telehealth.
In November 2021, a study published in JAMA Oncology revealed that cancer patients with a higher socioeconomic status were more likely to participate in an appointment through telehealth. Researchers noted that many lower-income people might not be able to obtain the necessary devices to participate in telehealth.
Another study from November 2021 noted that racial minorities and older adults were more likely to have trouble when participating in telehealth, along with those living in rural areas with a lower socioeconomic status. Researchers also noted that policymakers should consider patient needs in the future and work toward improving health equity.
Further, the high cost of care contributes to patient care access issues.
Data from the Integrated Benefits Institute (IBI) from July 2019 indicated that one-third of low-income workers faced healthcare disparities due to high medical costs. Using data from the Centers for Disease Control and Prevention, the IBI assessment revealed that families with incomes of $35,000 or less often neglected healthcare.