JMIR Publications

ABSTRACT

Background:

The Hispanic community represents a sizeable community that experiences inequities in the United States healthcare system. As the system has moved toward digital health platforms, it is critical that evaluate the potential impact for Hispanic communities

Objective:

The study aimed to investigate demographic, socioeconomic, and behavioral factors that contribute to low telehealth utilization in Hispanic communities.

Methods:

A retrospective observation study design was employed to examine the study objectives. The COVID-19 Research Database Consortium provided the AnalyticsIQ Peoplecore Consumer data and Office Alley claims data. The study period was from March 2020 to April 2021. Multiple logistic regression was used to determine the odds of using telehealth services.

Results:

We examined 3,478,287 unique Hispanic patients, of whom 16.63% used telehealth. Results suggested that patients aged 18-44 were more likely to use telehealth [OR: 1.07 (C.I.: 1.05, 1.1); p<.001]) than patients aged 65+. Across all age groups, patients with high incomes were at least 20% more likely to use telehealth than patients with lower incomes (p <.001); patients who had a primary care physician, exhibited high medical utilization, or were interested in exercise were more likely to use telehealth (p < .05); patients who had unhealthy behaviors such as smoking and alcohol were less likely to use telehealth (p < .001). Male patients were less likely than females to use telehealth among patients aged 65 and above [OR: 0.94 (C.I.: 0.93, 0.95); p<.001], while male patients aged 18 to 44 were more likely to use telehealth [OR: 1.05 (C.I.: 1.03, 1.07); p < .001]. Among patients younger than 65, full-time employment was positively associated with telehealth use (p<.001). Patients aged 18-44 with high school or less education are 2% less likely to use telehealth [OR: 0.98 (C.I.: 0.97, 0.99); p = .005]. Results also revealed a positive association with using WebMD among patients above 44 years old (p<.001), while there was a negative association with online prescriptions among those who are under 65 years old (p< .01).

Conclusions:

To prevent exacerbation of the health inequities in telehealth, we recommend interventions to bolster education, income, employment, and health behaviors. We make the following recommendations: increase access to health insurance and primary care providers and provide fiscal and educational resources.