Abstract: TH-PO724
Investigating Disparities in Telehealth Among CKD Patients in a US Integrated Healthcare System
Session Information
- Diversity and Equity in Kidney Health - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Zhou, Hui, KPSC Research and Evaluation, Pasadena, California, United States
- Zhou, Matt Mengnan, KPSC Research and Evaluation, Pasadena, California, United States
- Mccarthy, Donald P., KPSC Research and Evaluation, Pasadena, California, United States
- Sidell, Margo A., KPSC Research and Evaluation, Pasadena, California, United States
- Broder, Benjamin, KPSC Research and Evaluation, Pasadena, California, United States
- Dolan, Emma L., Southern California Permanente Medical Group, Pasadena, California, United States
- Morena, Anthony, Southern California Permanente Medical Group, Pasadena, California, United States
- Sim, John J., Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, United States
Background
Telehealth utilization, including the use of telephone appointments (TAV) and video appointment visits (VAV), are a valuable alternative to in-person visits and were a crucial form of health delivery during the COVID-19 national emergency. Among chronic kidney disease (CKD) patients within an integrated healthcare system, we evaluated the rate of successfully completed telehealth visits and assess differences in adoption using an equity lens.
Methods
A retrospective cohort study was conducted among individuals (age≥18yrs) with CKD stage 3 and 4 receiving care at Kaiser Permanente Southern California (KPSC). We limited our sample to patients with at least one in-person visit within 12 months prior to Mar 1, 2020 and followed them for 1 year. A successfully completed telehealth visit was defined as a ≥20 min completed appointment via TAV/VAV. Poisson regression with robust variance error was conducted to estimate the rate ratio for a successful telehealth visit.
Results
Of 161,088 patients, 74% (N=118,456 ) had ≥ 1 successfully completed telehealth visit, 34% of which were VAVs. Younger age, female gender, white race, and English as spoken language were associated with the successful completion of a telehealth visit. Senior persons (85+) were less likely to have a successfully TAV/VAV compared to young adults (18-34 yrs) (RR:0.82; 95% CI:0.79-0.86) (Figure). Those having a KPSC online account were more likely to have successful TAV/VAV (RR:1.11; 95% CI:1.10-1.12). Medicaid patients had more successful telehealth visits while patients living in neighborhoods with less internet access were marginally less likely to have successful TAV/VAV (p=0.05).
Conclusion
We observed disparities in adoption of telehealth care among CKD patients within an integrated health system. Our findings suggest that further studies and management strategies are needed to facilitate and improve equitable patient-centered care.
Funding
- Private Foundation Support