A digital divide in telemedicine use between rural and concrete communities elevated after the onset of the COVID-19 pandemic, significantly inside psychological well being integration providers, in response to a examine published in JAMA Network Open.
The examine evaluated 3.6 million psychological well being integration visits and 63.5 million main care visits throughout 138 Veterans Affairs healthcare methods nationwide from March 16, 2019, to December 15, 2021.
Throughout the cohort, 6.3 million distinctive sufferers with a mean age of 61 years had been included within the examine, of which 90.5% had been males. The vast majority of sufferers (66.3%) recognized as non-Hispanic White, whereas 17.2% had been non-Hispanic Black sufferers.
The observational examine included 45 rural and 93 city VA healthcare methods.
Earlier than the pandemic, 34% of rural VA healthcare methods used telemedicine for main care providers in comparison with 30% use in city areas. Nonetheless, after the onset of the pandemic, solely 55% of rural methods used telehealth for primacy care in contrast with 61% in city areas.
For psychological well being integration providers, rural methods reported higher telemedicine use at 29% in contrast with city methods at 25% earlier than the pandemic. As soon as the pandemic started, 76% of rural methods used telehealth for this objective, in contrast with 84% of city methods.
There have been few video visits pre-pandemic in rural and concrete healthcare methods, 2% vs. 1%, respectively. These numbers elevated barely to 4% in rural areas and eight% in city areas post-pandemic.
“Regardless of a coordinated federal response, the VA healthcare system’s expertise means that growing telemedicine use could go away rural sufferers in danger for poor entry to care. Future analysis and implementation efforts for healthcare methods should deal with rural-urban structural inequities (eg, web bandwidth) and think about tailoring expertise to encourage adoption amongst rural customers in any respect ranges (sufferers, clinicians and healthcare methods),” the researchers wrote.
“As healthcare methods more and more depend on telemedicine to ship mandatory medical providers, rural hospitals could also be topic to higher operational challenges, and rural sufferers could also be topic to growing inequity in entry to care in contrast with their city counterparts.“
WHY IT MATTERS
Researchers famous limitations, together with the potential for misclassifying some rural sufferers. Additionally they lacked information on VA sufferers who obtained non-VA care of their neighborhood, which can be extra frequent for rural veterans.
Lastly, the examine’s generalizability could also be restricted to well being methods with early telemedicine infrastructure, although researchers famous the implications would possible apply to most methods which have adopted telemedicine.