• J Gen Intern Med · Sep 2023

    Racial, Ethnic, and Socioeconomic Differences in Primary Care No-Show Risk with Telemedicine During the COVID-19 Pandemic.

    • Dania A Shah, Rustan Sharer, Dana Sall, Curt Bay, Alethea Turner, Dmitry Bisk, Wesley Peng, Benjamin Gifford, Jennifer Rosas, and Priya Radhakrishnan.
    • HonorHealth Internal Medicine, Phoenix, AZ, USA. dania.aijaz.shah@gmail.com.
    • J Gen Intern Med. 2023 Sep 1; 38 (12): 273427412734-2741.

    BackgroundThe coronavirus 2019 (COVID-19) pandemic resulted in rapid implementation of telemedicine. Little is known about the impact of telemedicine on both no-show rates and healthcare disparities on the general primary care population during the pandemic.ObjectiveTo compare no-show rates between telemedicine and office visits in the primary care setting, while controlling for the burden of COVID-19 cases, with focus on underserved populations.DesignRetrospective cohort study.SettingMulti-center urban network of primary care clinics between April 2021 and December 2021.ParticipantsA total of 311,517 completed primary care physician visits across 164,647 patients.Main MeasuresThe primary outcome was risk ratio of no-show incidences (i.e., no-show rates) between telemedicine and office visits across demographic sub-groups including age, ethnicity, race, and payor type.ResultsCompared to in-office visits, the overall risk of no-showing favored telemedicine, adjusted risk ratio of 0.68 (95% CI 0.65 to 0.71), absolute risk reduction (ARR) 4.0%. This favorability was most profound in several cohorts with racial/ethnic and socioeconomic differences with risk ratios in Black/African American 0.47 (95% CI 0.41 to 0.53), ARR 9.0%; Hispanic/Latino 0.63 (95% CI 0.58 to 0.68), ARR 4.6%; Medicaid 0.58 (95% CI 0.54 to 0.62) ARR 7.3%; Self-Pay 0.64 (95% CI 0.58 to 0.70) ARR 11.3%.LimitationThe analysis was limited to physician-only visits in a single setting and did not examine the reasons for visits.ConclusionAs compared to office visits, patients using telemedicine have a lower risk of no-showing to primary care appointments. This is one step towards improved access to care.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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