- Female patients and younger adults aged 18 to 44 are more likely to choose a telemedicine visit than male patients or patients of other ages, according to new research published in JAMA Network Open conducted prior to the COVID-19 pandemic.
- The study, which analyzed data from 1.1 million patients with primary care appointments through Kaiser Permanente Northern California's online patient portal between January 2016 and May 2018, found just 14% of appointments were conducted via telemedicine, primarily via telephone.
- However, though the majority of patients preferred an in-person visit, people with greater access to technology and those facing transportation or logistical barriers to care were more likely to select a virtual visit. Similarly, patients were more likely to choose a telemedicine visit if it was with their personal primary care clinician, opposed to a new doctor.
The COVID-19 pandemic and resulting stay-at-home orders led to a rapid adoption of telehealth services among both providers and patients. The new findings, however, offer a glimpse of behaviors before the novel coronavirus surfaced.
Patients who chose virtual visits may have done so because their insurance plans require higher out-of-pocket costs for in-person visits compared to telehealth visits, researchers said. But other patient demographic characteristics, along with office visit barriers, were significantly associated with choosing telemedicine.
Patients with a drive time longer than 30 minutes were significantly more likely than those with a less than or equal to 20-minute drive time to choose telemedicine. They were also more likely to choose a telemedicine visit if a medical facility had free parking rather than a paid parking structure.
Internet access, too, continues to be a barrier for widespread telehealth access. Those living in neighborhoods with high rates of residential internet access were more likely to choose video visits than those in areas with limited access.
Patients living in lower socioeconomic status neighborhoods were significantly less likely to choose video visits than other groups. And those with documented non–English language preferences were significantly less likely to choose either type of telemedicine than English speakers.
Researchers found that Black patients were significantly more likely than white patients to choose both types of telemedicine, while Hispanic patients were only less likely than white patients to choose video. Asian patients were more likely than white patients to choose video but less likely than white patients to choose telephone.
After adjustment, Black patients were more likely to choose both phone and video visits than any other race.