Zhang Yunxi, Lal Lincy S, Chandra Saurabh, Swint John Michael
University of Mississippi Medical Center, Jackson, MS, USA.
The University of Texas Health Science Center at Houston, TX, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251323983. doi: 10.1177/21501319251323983. Epub 2025 Apr 12.
The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.
A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.
Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to disability or End Stage Renal Disease. During the pandemic, telehealth users exhibited higher Charlson Comorbidity Index and Social Vulnerability Index but lower Digital Divide Index scores compared to non-telehealth users. Telehealth was associated with more primary care visits, broader access, and higher continuity of care. Primary care physicians increased their share of telehealth services to 39%, while specialties such as neuropsychiatry and psychiatry showed the highest adoption rates, reaching 55% and 38%, respectively.
Telehealth demonstrated a growing role in primary care during the pandemic. Future efforts must address digital divides and advance health equity when integrating telehealth into primary care services.
COVID-19大流行加速了远程医疗的采用，但在其使用方面的差异仍然存在。本研究调查了大流行之前和期间初级保健患者的社会人口学特征、远程医疗使用模式以及提供者的采用情况。
一项回顾性队列研究分析了2019年至2021年期间持续参加A、B和D部分医疗保险的密西西比州医疗保险受益人的数据，这些受益人接受了初级保健服务。
在201677名接受初级保健的医疗保险受益人中，1364人在大流行之前使用了远程医疗，而在大流行期间这一数字为73994人。在大流行期间，远程医疗的使用转向了更年轻、女性、白人受益人，以及因残疾或终末期肾病而参加医疗保险的人。在大流行期间，与非远程医疗用户相比，远程医疗用户的查尔森合并症指数和社会脆弱性指数更高，但数字鸿沟指数得分更低。远程医疗与更多的初级保健就诊、更广泛的就医机会和更高的护理连续性相关。初级保健医生将其远程医疗服务的份额提高到了39%，而神经精神病学和精神病学等专科的采用率最高，分别达到了55%和38%。
在大流行期间，远程医疗在初级保健中发挥了越来越重要的作用。未来在将远程医疗纳入初级保健服务时，必须解决数字鸿沟问题并促进健康公平。
