12/6/2023 0 Comments Telemedicine unite health![]() ![]() A drop in overall visit volume may be mitigated by telemedicine use given that some conditions are more amenable to telemedicine than others. 20, 21 The long-term impact of the deferred care during the COVID-19 pandemic may depend on the conditions and specialties for which clinical volumes fell the most. 19 Natural disasters, in which care may be interrupted for weeks or months, hamper chronic illness management and increase mortality over the long term. There is also uncertainty on the clinical impact of the substantial drop in outpatient visits observed as COVID-19 swept across the country. There are concerns that increased use of telemedicine during the pandemic may exacerbate health disparities due to the “digital divide,” defined as the absence of broadband or smart phone technology necessary for video telemedicine visits among disadvantaged populations. While the increase in telemedicine use during the pandemic is widely recognized, 12, 13 it is unclear how use of telemedicine and in-person care has varied across patient demographics, clinical specialties, and medical conditions. ![]() 8 For example, Medicare broadened telemedicine coverage to urban beneficiaries, 9 states relaxed restrictions around telemedicine provider licensing, 10 and many commercial insurers expanded reimbursement and waived copayments for telemedicine visits. 7 This expansion was facilitated by temporary waivers of many telemedicine regulations and expanded reimbursement. 1, 2, 3, 4, 5 After years of slow adoption, 6 many clinicians used telemedicine for the first time to limit patient and staff exposure to the virus. In response to the COVID-19 pandemic, telemedicine use dramatically grew within a matter of weeks. Higher rates of telemedicine use for common conditions were associated with smaller decreases in total weekly visits during the pandemic. Across common conditions, the percentage of visits provided during the pandemic via telemedicine ranged from 53% for depression to 3% for glaucoma. Across specialties, the use of any telemedicine during the pandemic ranged from 68% of endocrinologists to 9% of ophthalmologists. 26.5% for enrollees residing in counties with lowest vs. Telemedicine use was highest in communities with more minority residents (34.3% vs. During the pandemic, 30.1% of all visits were provided via telemedicine, and the weekly number of visits increase 23-fold compared to the pre-pandemic period. We examined the variation in total outpatient visits and telemedicine use across patient demographics, specialties, and conditions in a database of 16.7 million commercially insured and Medicare Advantage enrollees from January to June 2020. COVID-19 spurred a rapid rise in telemedicine, but it is unclear how use has varied by clinical and patient factors during the pandemic.
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