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Srinivasan Y, Andreadis K, Ballakur SS, Rameau A. Access to Otolaryngologic Telemedicine Care Across the COVID-19 Pandemic at an Urban Tertiary Hospital System. EAR, NOSE & THROAT JOURNAL 2024; 103:76S-84S. [PMID: 38488168 DOI: 10.1177/01455613241240560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Objective: To describe associations between patients' demographic characteristics and access to telemedicine services in an urban tertiary academic medical system across the COVID-19 pandemic, and to identify potential barriers to access. Methods: This was a retrospective cohort study conducted at a single-center tertiary academic medical center. The study included adult patients undergoing outpatient otolaryngologic care in person or via telemedicine during 8 week timeframes: before the pandemic, at the onset of the pandemic, and during later parts of the pandemic. Patients were characterized by age, sex, race, insurance type, primary language, portal activation status, income estimate, and visit type. Where appropriate, chi-squared tests, Wilcoxon signed-rank tests, and logistic regression were used to compare demographic factors between the cohorts. Results: A total of 14,240 unique patients [median age, 58 years (range, 18-107 years); 56.5% were female] resulting in a total of 29,457 visits (94.8% in-person and 5.2% telemedicine) were analyzed. Patients seen in person were older than those using telemedicine. Telemedicine visits included a higher proportion of patients with private insurance, and fewer patients with government or no insurance compared to in-person visits. Race, income, and English as primary language were not found to have a significant effect on telemedicine use. Conclusion: In an urban tertiary medical center, we found significant differences in sociodemographic characteristics between patients who accessed otolaryngologic care in person versus via telemedicine through different phases of the COVID pandemic, reflecting possible barriers to care associated with telemedicine. Further studies are needed to develop interventions to improve access.
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Affiliation(s)
- Yashes Srinivasan
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Katerina Andreadis
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Sarita S Ballakur
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Anaïs Rameau
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
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Ettman CK, Brantner CL, Albert M, Goes FS, Mojtabai R, Spivak S, Stuart EA, Zandi PP. Trends in Telepsychiatry and In-Person Psychiatric Care for Depression in an Academic Health System, 2017-2022. Psychiatr Serv 2024; 75:178-181. [PMID: 37554006 PMCID: PMC10862532 DOI: 10.1176/appi.ps.20230064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The authors aimed to assess differences in appointment completion rates between telepsychiatry and in-person outpatient psychiatric care for patients with depression in an academic health system. METHODS Electronic health records of encounters for patients (ages ≥10) with a depression diagnosis and at least one scheduled outpatient psychiatric appointment (N=586,266 appointments; November 2017-October 2022) were assessed for appointment volume and completion of telepsychiatry versus in-person sessions. RESULTS Telepsychiatry became the dominant care modality after the onset of the COVID-19 pandemic, although the number of telepsychiatry and in-person appointments nearly converged by October 2022. Logistic regression showed that telepsychiatry appointments (July 2020-October 2022) were more likely (OR=1.30, 95% CI=1.27-1.34) to be completed than in-person appointments. CONCLUSIONS Telepsychiatry appointments were less likely to be canceled or missed than in-person appointments, suggesting that telepsychiatry improved efficiency and continuity of care. As in-person operations resume following the pandemic, maintaining telepsychiatry services may optimize hospital-level and patient outcomes.
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Affiliation(s)
- Catherine K Ettman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Carly L Brantner
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Michael Albert
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Fernando S Goes
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Stanislav Spivak
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
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