PMID- 38517424 OWN - NLM STAT- MEDLINE DCOM- 20240325 LR - 20240325 IS - 2689-0186 (Electronic) IS - 2689-0186 (Linking) VI - 5 IP - 3 DP - 2024 Mar 1 TI - Racial and Ethnic Differences in Telemedicine Use. PG - e240131 LID - 10.1001/jamahealthforum.2024.0131 [doi] LID - e240131 AB - IMPORTANCE: Individuals of racial and ethnic minority groups may be less likely to use telemedicine in part due to lack of access to technology (ie, digital divide). To date, some studies have found less telemedicine use by individuals of racial and ethnic minority groups compared with White individuals, and others have found the opposite. What explains these different findings is unclear. OBJECTIVE: To quantify racial and ethnic differences in the receipt of telemedicine and total visits with and without accounting for demographic and clinical characteristics and geography. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included individuals who were continuously enrolled in traditional Medicare from March 2020 to February 2022 or until death. EXPOSURE: Race and ethnicity, which was categorized as Black non-Hispanic, Hispanic, White non-Hispanic, other (defined as American Indian/Pacific Islander, Alaska Native, and Asian), and unknown/missing. MAIN OUTCOMES AND MEASURES: Total telemedicine visits (audio-video or audio); total visits (telemedicine or in-person) per individual during the study period. Multivariable models were used that sequentially adjusted for demographic and clinical characteristics and geographic area to examine their association with differences in telemedicine and total visit utilization by documented race and ethnicity. RESULTS: In this national sample of 14 305 819 individuals, 7.4% reported that they were Black, 5.6% Hispanic, and 4.2% other race. In unadjusted results, compared with White individuals, Black individuals, Hispanic individuals, and individuals of other racial groups had 16.7 (95% CI, 16.1-17.3), 32.9 (95% CI, 32.3-33.6), and 20.9 (95% CI, 20.2-21.7) more telemedicine visits per 100 beneficiaries, respectively. After adjustment for clinical and demographic characteristics and geography, compared with White individuals, Black individuals, Hispanic individuals, and individuals of other racial groups had 7.9 (95% CI, -8.5 to -7.3), 13.2 (95% CI, -13.9 to -12.6), and 9.2 (95% CI, -10.0 to -8.5) fewer telemedicine visits per 100 beneficiaries, respectively. In unadjusted and fully adjusted models, and in 2019 and the second year of the COVID-19 pandemic, Black individuals, Hispanic individuals, and individuals of other racial groups continued to have fewer total visits than White individuals. CONCLUSIONS AND RELEVANCE: The results of this cross-sectional study of US Medicare enrollees suggest that although nationally, Black individuals, Hispanic individuals, and individuals of other racial groups received more telemedicine visits during the pandemic and disproportionately lived in geographic regions with higher telemedicine use, after controlling for geographic region, Black individuals, Hispanic individuals, and individuals of other racial groups received fewer telemedicine visits than White individuals. FAU - Marcondes, Felippe O AU - Marcondes FO AD - Division of General Internal Medicine, Massachusetts General Hospital, Boston. FAU - Normand, Sharon-Lise T AU - Normand ST AD - Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. AD - Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts. FAU - Le Cook, Benjamin AU - Le Cook B AD - Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts. AD - Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. FAU - Huskamp, Haiden A AU - Huskamp HA AD - Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. FAU - Rodriguez, Jorge A AU - Rodriguez JA AD - Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Barnett, Michael L AU - Barnett ML AD - Harvard T. H. Chan School of Public Health, Boston, Massachusetts. FAU - Uscher-Pines, Lori AU - Uscher-Pines L AD - RAND Corporation, Arlington, Virginia. FAU - Busch, Alisa B AU - Busch AB AD - Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. AD - McLean Hospital, Belmont, Massachusetts. FAU - Mehrotra, Ateev AU - Mehrotra A AD - Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. AD - Beth Israel Deaconess Medical Center, Boston, Massachusetts. LA - eng PT - Journal Article DEP - 20240301 PL - United States TA - JAMA Health Forum JT - JAMA health forum JID - 101769500 SB - IM MH - Aged MH - Humans MH - United States MH - *Ethnicity MH - Cross-Sectional Studies MH - *Pandemics MH - Minority Groups MH - Medicare PMC - PMC10960201 COIS- Conflict of Interest Disclosures: Dr Huskamp reported grants from the National Institute of Mental Health (NIMH) during the conduct of the study. Dr Barnett reported personal fees from the California Department of Health Care Services outside the submitted work. Dr Busch reported grants from the NIMH, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, and CRICO Risk Management Foundation during the conduct of the study. Dr Mehrotra reported grants from NIMH during the conduct of the study as well as personal fees from Black Opal Ventures and the Commonwealth of Massachusetts outside the submitted work. No other disclosures were reported. EDAT- 2024/03/22 12:45 MHDA- 2024/03/25 06:42 PMCR- 2024/03/22 CRDT- 2024/03/22 11:33 PHST- 2024/03/25 06:42 [medline] PHST- 2024/03/22 12:45 [pubmed] PHST- 2024/03/22 11:33 [entrez] PHST- 2024/03/22 00:00 [pmc-release] AID - 2816752 [pii] AID - aoi240007 [pii] AID - 10.1001/jamahealthforum.2024.0131 [doi] PST - epublish SO - JAMA Health Forum. 2024 Mar 1;5(3):e240131. doi: 10.1001/jamahealthforum.2024.0131.