好色先生

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Abstract Details

Minorities, Socioeconomic Disadvantaged, and Older Patients have Decreased Utilization of Telehealth for Neurological Conditions
Health Care Disparities
S29 - Health Care Disparities (3:54 PM-4:06 PM)
003

To characterize telehealth utilization for neurological conditions and identify potential disparities in utilization.

Telehealth has the potential to improve access to neurological care, but there is a need to understand telehealth utilization to ensure equitable healthcare delivery. 

All outpatient visits conducted by neurology clinicians at the Cleveland Clinic for patients ≥18 years from 7/2020 to 7/2022 were included. Patients with fully in-person care were compared to patients with a combination of telehealth and in-person care. Visits were analyzed using a generalized linear mixed effects model to predict telehealth or in person visit type, using fixed effects of age, race, ethnicity, gender, location, rural-urban commuting areas codes (RUCA), area deprivation index (ADI), insurance, provider, language, and visit completion, and random intercept of subjects. Significance was set at p<0.001.
192,556 patients (mean age 54.8 years, 59.4% female, 80.1% white, 3.4% Hispanic, 37.6% Medicare, mean visits 7.4 ) completed a total of 584,900 visits during the study timeframe. In-person visits were completed by older (57.8 vs 49.4 years), higher ADI (23.0% vs 20.3% 4th quartile), Black (12.3% vs 9.7%), Hispanic (3.2% vs 3.1%), male (41.2% vs 34.3%), local (72.2% vs 65.4%), metropolitan (85.8% vs 80.4%), and Medicare (45.5% vs 29.5%) individuals compared to telehealth visits. Odds of a visit being telehealth were significantly lower for older (OR 0.96), Black (OR 0.80), Hispanic (OR 0.79), higher ADI quartile (4th quartile OR 0.62), Medicaid (OR 0.77), Medicare (OR 0.80), self-pay (0.48), micropolitan (OR 0.83), and non-English primary language (OR 0.35) patients.

The COVID-19 pandemic expanded access to telehealth care, but disparities remain in utilization most notable for older, Black, Hispanic, and lower socioeconomic status individuals. Efforts are needed to understand patient barriers and preferences to telehealth along with legislation needed to facilitate equitable healthcare delivery.
Authors/Disclosures
Marisa P. McGinley, DO (Cleveland Clinic)
PRESENTER 		Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. McGinley has received research support from Biogen. The institution of Dr. McGinley has received research support from Genentech. The institution of Dr. McGinley has received research support from NIH. The institution of Dr. McGinley has received research support from AHRQ.
Tucker Harvey (Cleveland Clinic, LRI, Quantitative Health Sciences) No disclosure on file
Allison L. Weathers, MD, FAAN (Cleveland Clinic) Dr. Weathers has received personal compensation in the range of $500-$4,999 for serving as a CME question writer, interviewer, presenter with 好色先生. Dr. Weathers has a non-compensated relationship as a Chair, Neurology Adult Steering Board with Epic that is relevant to AAN interests or activities. Dr. Weathers has a non-compensated relationship as a Member, Quality Informatics Subcommittee with 好色先生 that is relevant to AAN interests or activities. Dr. Weathers has a non-compensated relationship as a Member of the NCP Editorial Board with 好色先生 that is relevant to AAN interests or activities.
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic) Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.