Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic
Authors' conclusion
During the first year of the pandemic, the sociodemographic characteristics of patients receiving cardiovascular care remained stable, but the modality of care diverged across groups. There were differences in the use of telemedicine vs in-person care and most notably in the use of video- vs phone-based telemedicine.
Study context
- Population
- All adult cardiology visits at an academic and an affiliated community practice in Northern Californiavisits
- Participants
- 54,948 vs 58,940
- Exposure
- COVID period vs pre-COVID period; telemedicine vs in-person and video vs phone telemedicine by sociodemographic group
- Pre-COVIDn = 54,948reference
- COVIDn = 58,940
- Outcome
- Visit modality (in-person vs telemedicine; video- vs phone-based telemedicine)
- Follow-up
- COVID period
Methodological detailsacademic and affiliated community practice
- Academic and affiliated community practice
Main finding
As reported in the abstract
Telemedicine use
| Group | Value | Video | Phone |
|---|---|---|---|
| Pre-COVID | <1% | ||
| COVID | 70.7% | 49.7% | 21.0% |
Value
Pre-COVID<1%
COVID70.7%
Video
Pre-COVIDNot reported in the abstract
COVID49.7%
Phone
Pre-COVIDNot reported in the abstract
COVID21.0%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Video- vs phone-based telemedicine, by sociodemographic group (adjusted) · COVID periodAge ≥80 years vs Age <60 · adjusted analyses | 0.24 (0.21–0.28) | |
| Video- vs phone-based telemedicine, by sociodemographic group (adjusted) · COVID periodBlack vs Non-Hispanic White · adjusted analyses | 0.64 (0.56–0.74) | |
| Video- vs phone-based telemedicine, by sociodemographic group (adjusted) · COVID periodLimited English proficiency vs English proficient · adjusted analyses | 0.52 (0.46–0.59) | |
| Video- vs phone-based telemedicine, by sociodemographic group (adjusted) · COVID periodMedicaid vs Privately insured · adjusted analyses | 0.47 (0.41–0.54) | |
| 0.20.5125Odds ratio (log scale) |
Video- vs phone-based telemedicine, by sociodemographic group (adjusted) · COVID period
- Visits for some sociodemographic groups less likely by telemedicine, and when by telemedicine less likely by video vs phone
Original publication
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic. Am Heart J. Published 25 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it