Differences in telehealth modality underline disparities: 5 things to know

While telehealth took off during the COVID-19 pandemic, it has also been marred by inequitable use and access. A new study reveals demographic disparities in telehealth usage depending on whether patients access those services via video or audio call.

The study, released Feb. 1 and conducted by HHS, analyzed national trends in utilization of video versus audio telehealth services and identified usage disparities between the modalities. HHS used data from the Census Bureau’s Household Pulse Survey from April to October 2021 to understand general telehealth usage, adding modality specifications from July to October 2021 to understand the types of telehealth being used. In total, 808,368 adults responded to the survey and 670,155 answered the telehealth question.

Here are five things to know:

  1. Almost one-quarter (23.1 percent) of respondents reported using telehealth within the previous month. 

  2. Telehealth use was low among those based in the Midwest (19 percent utilization) and the uninsured (9.4 percent). It was high among those on Medicaid or Medicare (29.3 percent and 27.4 percent, respectively), Black individuals (26.8 percent) and respondents earning less than $25,000 (26.7 percent).

  3. The demographic data of those who use video telehealth services favors the young, rich and white. Among telehealth video users, 72.5 percent were between ages 18 and 24, 68.8 percent earned at least $100,000, 61.9 percent were white and 65.9 percent had private insurance.

  4. Video telehealth rates were lowest among respondents without a high school diploma (38.1 percent) and among people older than 65 (43.5 percent).

  5. The report argues these disparities may be causing difficulties for those who cannot access video calls, stating: "While a phone visit may provide needed access to care in some circumstances, a video appointment may allow a partial physical exam, nonverbal communication, and a stronger patient-provider relationship. Moreover, a video visit may allow the provider to check on a patient’s home environment, where conditions and family well-being are often intertwined with health."

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