Research Report Variation in Patients' Use of, Experiences with, and Access to Telehealth during the First Year of the COVID-19 Pandemic
Laura B. Smith, Fredric Blavin, Claire O'Brien
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When the COVID-19 public health emergency was first declared in March 2020, policymakers and payers implemented many changes to facilitate an abrupt increase in telehealth. Little is known about the prevalence of and patients’ experiences with telehealth visits since that time. Using a nationally representative, internet-based survey of 12,224 US adults, we examine the factors associated with telehealth visits, the characteristics of and patient experiences with telehealth visits, and access to telehealth visits during the first year of the pandemic.

Results

  • During the first year of the pandemic, 37.4 percent of nonelderly adults and 46.2 percent of elderly adults had at least one telehealth.
  • Telehealth visits were more common among adults with high incomes, adults with health insurance coverage, adults in fair or poor health, and adults living in metropolitan areas.
  • Publicly insured nonelderly adults were more likely to have had a phone visit, as opposed to a video visit, than those with private insurance, which may reflect differences in patient access to video technology or the telehealth modalities insurers cover.
  • Telehealth visits most often addressed general preventive or routine health care issues, and the majority of telehealth users reported their telehealth visits were convenient and low cost. While most adults did not report issues with accessing telehealth, we found disparities in access to telehealth based on income and health.

Discussion

As policymakers face consequential decisions about the permanence of pandemic-era changes to telehealth regulation, having evidence on patient experiences with telehealth is critical. Our findings suggest that the overall demand for telehealth visits will remain high after the pandemic subsides, especially if telehealth visits continue to be convenient, easy to schedule, and low cost at the point of service for most insured individuals. However, the uneven use of telehealth across patients that we identify should serve as caution. Careful policymaking will be necessary to ensure that increased reliance on telehealth after the public health emergency ends does not further exacerbate existing health disparities. Telehealth policies should promote access to telehealth, especially video technology, for people with low incomes, people with public health insurance coverage and people who are uninsured, people in poor health, and rural populations.

Research Areas Health and health care
Tags Federal health care reform Health care delivery and payment
Policy Centers Health Policy Center