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Older adults, non-English speakers less likely to use telemedicine

Older adults, non-English speakers less likely to use telemedicine
A new study shows some groups of people have had access-to-care issues associated with telemedicine during the COVID-19 pandemic. File Photo by Rawpixelcom/Shutterstock

Dec. 29 (UPI) -- Older adults, Asian Americans and non-English speakers have been much less likely to complete scheduled telemedicine visits during the COVID-19 pandemic than those in other demographic groups, a study published Tuesday by JAMA Network Open found.

The findings suggest that many of these patients are uncomfortable with the technology needed to complete medical appointments virtually, or they lack access to it, study co-author Dr. Srinath Adusumalli told UPI.

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"Telemedicine is a great way to maintain access to care during the pandemic," said Adusumalli, a cardiologist at Penn Medicine in Philadelphia.

Although the ability to conduct follow-up medical appointments virtually "may be one of the silver linings" of COVID-19, "we need to ensure there is access to care for all patients, equally," he said.

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Use of telemedicine, in which patients consult with clinicians either by phone or online, has risen since the start of pandemic earlier this year, with virtual visits expected to reach 1 billion by year's end.

The rise has been fueled by patient reluctance to visit health facilities during the pandemic over fears that they will be exposed to someone with the virus.

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However, concerns exist that the shift to telemedicine will effectively shut out those who either don't have access to the necessary technology or lack familiarity with it, Adusumalli said.

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This includes people who don't have a cellphone or wireless and broadband connectivity, as well as those unable to access these services because their health systems do not provide interpreters for non-English speakers, he said.

For this study, Adusumalli and his colleagues reviewed data on 148,402 scheduled telemedicine visits at Penn Medicine primary care and specialty ambulatory clinics between March 16 and May 11, when the pandemic was raging in the northeastern United States.

Of these visits, 80,780, or 54%, were completed, with about 46% done primarily by video chat, and 57% involving a telephone call, the researchers said.

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People age 55 to 64 were 15% less likely than younger adults to complete medical appointments using these methods, while those aged 65 to 74 years were 25% less likely to do so, and those over 75 were 33% less likely, according to the researchers.

People age 55 to 74 were just over 20% less likely than younger adults to use the technology and those over 75 were 51% less likely to use it, the data showed.

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Black and Latinx people were 35% and 10% less likely White people, respectively, to use the technology during telemedicine consultations, while those with household incomes less than $50,000 per year were 43% less likely to do so.

Asian Americans were 31% less likely than White people to use telemedicine platforms while non-English-speaking patients were 16% less likely than English-speakers to do so, the researchers said.

"We have seen how COVID-19 has been the great unequalizer," study co-author Dr. Lauren A. Eberly told UPI.

"The findings of this study demonstrate significant inequities are also present among patients in accessing necessary telemedicine care, [and] these results call for immediate implementation of strategies to ensure more equitable access," said Eberly, a cardiovascular fellow at Penn Medicine.

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