School of Medicine, University of California Irvine, Irvine, California, USA.
Department of Health, Society and Behavior, Program of Public Health, University of California Irvine, Irvine, California, USA.
Cancer Med. 2024 Sep;13(18):e70099. doi: 10.1002/cam4.70099.
The COVID-19 pandemic prompted a surge in telehealth utilization. However, language barriers have emerged as a potential obstacle to effective telemedicine engagement, impacting millions of limited English proficient (LEP) individuals. Understanding the role of language spoken in telehealth outcomes is critical, particularly in cancer care, in which consistent follow-up and communication are vital. The primary objective was to assess the impact of telehealth utilization and primary language spoken on clinical outcomes in cancer patients.
This study utilized a retrospective cohort design, encompassing cancer patients seen at the Chao Family Comprehensive Cancer Center between March 1, 2020, and December 31, 2022. The study incorporated both in-person and telehealth visits, examining the association between encounter type and clinical outcomes.
The study included 7890 patients with more than one outpatient visit during the study period. There was decreased telehealth utilization in non-English speaking cancer patients throughout the pandemic. Increased telehealth utilization was associated with higher rates of admission, irrespective of cancer type. Additionally, telehealth visits were associated with longer duration of subsequent admissions compared to in-person visits. Spanish-speaking patients utilizing telehealth had higher rates of re-admission compared to English speakers utilizing telehealth. Patients who died had higher rates of telehealth utilization compared to patients who survived.
This study demonstrates that primary language spoken is associated with differences in telehealth utilization and associated outcomes in cancer patients. These differences suggest that the interplay of telehealth and language could contribute to widening of disparities in clinical outcomes in these populations. The study underscores the need to optimize telehealth usage and minimize its limitations to enhance the quality of cancer care in a telehealth-driven era.
COVID-19 大流行促使远程医疗的使用激增。然而，语言障碍已成为有效远程医疗参与的潜在障碍，影响了数以百万计的有限英语能力（LEP）个体。了解远程医疗结果中使用的语言的作用至关重要，尤其是在癌症护理中，持续的随访和沟通至关重要。主要目的是评估远程医疗的使用和主要语言对癌症患者临床结果的影响。
本研究采用回顾性队列设计，包括 2020 年 3 月 1 日至 2022 年 12 月 31 日期间在 Chao 家族综合癌症中心就诊的癌症患者。该研究纳入了面对面和远程医疗就诊，考察了就诊类型与临床结果之间的关系。
该研究纳入了 7890 名在研究期间有一次以上门诊就诊的患者。在整个大流行期间，非英语癌症患者的远程医疗利用率下降。无论癌症类型如何，增加远程医疗的使用与更高的入院率相关。此外，与面对面就诊相比，远程医疗就诊与随后入院的持续时间更长相关。使用远程医疗的西班牙语患者的再入院率高于使用远程医疗的英语患者。与存活患者相比，死亡患者的远程医疗使用率更高。
本研究表明，主要语言与癌症患者远程医疗使用和相关结果的差异有关。这些差异表明，远程医疗和语言的相互作用可能导致这些人群临床结果差异的扩大。该研究强调了优化远程医疗使用并最小化其局限性以在远程医疗驱动的时代提高癌症护理质量的必要性。
