K. Keener1, D. Wilson1, E. Abebrese1 1Medical College Of Wisconsin, Surgery, Milwaukee, WI, USA
Introduction:
The COVID-19 pandemic markedly accelerated investment in and adoption of Telehealth for healthcare delivery. For many conditions, Telehealth provides convenience and travel cost savings in comparison to in-person encounters for pediatric patients and their caregivers.
However, despite the continued availability of Telehealth, utilization has declined overall at our tertiary pediatric referral hospital. We first aimed to understand trends in Telehealth usage since the COVID-19 pandemic for patients in our specialty, Pediatric Surgery. Second, since identifying patient and caregivers’ preferences for Telehealth use guides us in providing patient-centered care, we wanted to identify which patients were using it the most since the pandemic to target for further study. We hypothesized that patients in rural areas who benefit more from travel costs savings will be among the majority.
Methods:
A retrospective analysis of pediatric surgery telehealth visits at our tertiary pediatric referral hospital between 2020 to 2023 was conducted. Patient demographics and addresses were gathered. Zip codes were used to obtain the state-level Area Deprivation Index (ADI) for each patient, which categorizes socioeconomic deprivation from least disadvantaged (1) to most disadvantaged (10). Zip codes were also linked to 6 rural/urban classifications based on the University of Wisconsin’s Institute for Clinical and Translational Research’s Health Innovation Program’s Zip Code classifications. These classifications include Rural, Rural Underserved, Rural Advantaged, Urban, Urban Underserved, and Urban Advantaged. Utilization patterns across these groups were analyzed using descriptive statistics.
Results:
There were 1,861 scheduled telehealth encounters in this period, which grew from 29 encounters in 1st Quarter of 2020, 162 in the 4th Quarter. Telehealth encounters in 2021, 2022 and 2023 were 468, 513, and 478, respectively. From 2020 to 2023, Rural Advantaged, and Urban Advantaged had an increase in Telehealth encounters from 19 (15.8%) to 38 (31.7%), and 80 (20.4%) to 110 (28.1%) respectively, p=0.030.
Conclusion:
Telehealth utilization for pediatric surgery patients at our institution has varied by socioeconomic status and geographic location over time but has overall increased since the COVID-19 pandemic. Qualitative studies to investigate telehealth use preferences and barriers among patients and caregivers with low and high utilization rates will aid in understanding why these trends exist