PD46-09 PREDICTORS OF VIDEO VERSUS AUDIO-ONLY VISITS FOR UROLOGIC CARE DURING THE COVID-19 PANDEMIC

Abstract

INTRODUCTION AND OBJECTIVE: Most health insurance organizations have reimbursed both video and audio-only (i.e., phone) visits during the COVID-19 pandemic, but may discontinue phone visit coverage after the public health emergency. We sought to understand predictors of video versus audio-only (phone) visits for urologic patients during the COVID-19 pandemic. METHODS: We performed a retrospective review of outpatient urologic encounters at Michigan Medicine from April 1-June 30, 2020. Patients who used telehealth were divided into those with any video visits and those with only phone visits. We obtained demographic information including age, gender, race, ethnicity, need for an interpreter, primary insurance status, and home zip code. We compared use of video versus phone visit across the patient demographic, socioeconomic and geographic characteristics using multivariable analysis. RESULTS: There were 4,744 telehealth users and 2,068 patients (43.6%) received care through phone visits. Patient characteristics associated with lower probability of using video visits included age (average marginal effect [AME] -11.7% for patients between 19-64 years old and -38.3% for patients older than 65), Black/African- American (AME -10.2%) or American Indian/Alaska Native (AME -10.2%), need an interpreter (AME -4.5%), Medicaid as primary insurance (AME -13.3%), live in a rural zip code (AME -7.2%), and live in a zip code with low broadband access (AME -3.7 to -12.8% by quartile;Table). Most patients had more than one factor which further reduced their probability of using video visits. CONCLUSIONS: Age and other social determinants of health including race, geography, insurance status, and access to broadband internet were associated with decreased probability of using video to receive urologic care. This data suggests that without coverage and reimbursement of phone visits, video-only telehealth could exacerbate health disparities in access to urologic care. (Table Presented).