Pediatric, Urgent Care Telemedicine During COVID-19: A Comparative Analysis.

Abstract

Background: Telemedicine holds potential for improving access to care, but to what extent has it been realized? We examined telemedicine utilization within a pediatric health care system into the second year of the COVID-19 pandemic to illuminate maintenance of changes in patient diversity previously observed and to elucidate ongoing opportunities to support health equity. Materials and Methods: This IRB-approved study is a retrospective analysis of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between June 2020 and July 2021. Unique patient characteristics were compared with those from 2019 (baseline) and early pandemic. Results: Current study patients (n = 9,064) did not differ from patients in either prior time point (n = 5,462) in race, ethnicity, age, or sex (ps > 0.05). Thirteen preferred languages spoken, relative to 5 at the 2019 baseline. Telemedicine was utilized significantly more than baseline among patients accessing government-subsidized health insurance (p < 0.05); utilization among rural patients (1.2%) declined relative to baseline (p < 0.05). Discussion: This research examined demographic changes among patients utilizing urgent care telemedicine throughout the COVID-19 pandemic and illuminated the importance of sustaining the virtual care needs of a more diverse patient population. Conclusion: Unlocking telemedicine's potential has implications for improving health equity. Our research demonstrates that patients seeking virtual care in the "new normal" represent a greater demographic diversity than observed prepandemic. Mitigation strategies used during the pandemic to engage and support a diverse patient population, including regulatory waivers, technological outreach, and translation services, must continue in support of equitable access for all.