Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 26, 2024
Open Peer Review Period: Jun 26, 2024 - Jul 11, 2024
Date Accepted: Sep 24, 2024
(closed for review but you can still tweet)
Can Telehealth Mitigate Health Disparities Associated with Travel Time to Hospital for Patients with Recurrent Admissions: A Four-Year Panel Data Analysis
ABSTRACT
Background:
Geographic, demographic, and socioeconomic differences in health outcomes persist despite the global focus on these issues by health organizations. Barriers to accessing care contribute significantly to these health disparities. Among these barriers, those related to travel time—the time required for patients to travel from their residences to health facilities—remain understudied compared to others.
Objective:
This study aims to explore the impact of telehealth in addressing health disparities associated with travel time to hospitals for patients with recurrent hospital admissions. It specifically examines the role of telehealth in reducing in-hospital length-of-stay (LOS) for patients living farther from the hospital.
Methods:
We sourced the data from four datasets, and our final effective sample consisted of 1,600,699 admissions from 536,182 patients from 63 hospitals in New York and Florida in the United States from 2012 to 2015. We applied fixed-effect models to examine the direct effects and the interaction between telehealth and patients’ travel time to hospitals on LOS. We further conducted a series of robustness checks to validate our main models and performed post-hoc analyses to explore the different effects of telehealth across various patient groups.
Results:
We found that telehealth adoption is associated with a reduced LOS (p<.001) and that the impact of telehealth is more manifest for patients living farther from hospitals. We also found that telehealth adoption has a larger impact on patients frequently needing health services, patients living in high Internet coverage areas, and patients who have diseases with high virtualization potential.
Conclusions:
Our findings suggest that telehealth adoption can mitigate certain health disparities for patients living farther from hospitals. This study provides key insights for healthcare practitioners and policymakers on telehealth's role in addressing distance-related disparities and planning healthcare resources. It also has practical implications for hospitals in developing countries that are in the early stages of implementing telehealth.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.