Trends in telemedicine visits among pediatric asthma patients during COVID-19

Abstract

BackgroundEnvironmental and social factors, including lack of access to asthma care contribute to persistent inequities in asthma outcomes among children from historically marginalized racial and ethnic groups. Telemedicine, which expanded rapidly during the COVID-19 pandemic, may be an approach to augment access to pediatric asthma care. ObjectivesTo describe characteristics of pediatric (0-17 years) telemedicine users with asthma and characterize use trends throughout the COVID-19 pandemic. MethodsWe conducted a retrospective analysis using electronic health record data of pediatric patients with asthma seen at University of California, Los Angeles Medical Center between March 2019 to March 2022 describing (a) telemedicine user characteristics, (b) trends of asthma-related telemedicine use, and (c) associations between user characteristics and having a telemedicine visit. ResultsAmong 6,777 patients with asthma, the percentage of asthma-related telemedicine visits peaked early in the pandemic, comprising 74.3% of visits, before decreasing to 13.6% in 2022. Compared to White patients, Black patients had lower odds of an asthma telemedicine visit (0.49, 95% CI: 0.26, 0.94). Those with public insurance (1.7, 95% CI: 1.19, 2.43), severe persistent asthma (3.03, 95% CI: 1.70, 5.42), or comorbidities (1.59, 95% CI: 1.08, 2.33) had higher odds. Time to first emergency department visit and hospitalization comparing those with at least one telemedicine visit to those with none, were similar. ConclusionsMore pediatric asthma patients are using telemedicine since the COVID-19 pandemic, particularly those with medical complexity and comorbidities, and outcomes appear similar. However, Black patients at our institution have lower odds of using telemedicine.