Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study
BackgroundThe COVID-19 pandemic has led to a notable increase in telemedicine adoption. However, the impact of the pandemic on telemedicine use at a population level in rural and remote settings remains unclear. ObjectiveThis study aimed to evaluate changes in the...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
JMIR Publications
2021-04-01
|
Series: | Journal of Medical Internet Research |
Online Access: | https://www.jmir.org/2021/4/e26960 |
id |
doaj-00333738f8d04f64bd65a76209516bb6 |
---|---|
record_format |
Article |
spelling |
doaj-00333738f8d04f64bd65a76209516bb62021-04-05T14:47:42ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-04-01234e2696010.2196/26960Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional StudyChu, CherryCram, PeterPang, AndreaStamenova, VessTadrous, MinaBhatia, R Sacha BackgroundThe COVID-19 pandemic has led to a notable increase in telemedicine adoption. However, the impact of the pandemic on telemedicine use at a population level in rural and remote settings remains unclear. ObjectiveThis study aimed to evaluate changes in the rate of telemedicine use among rural populations and identify patient characteristics associated with telemedicine use prior to and during the pandemic. MethodsWe conducted a repeated cross-sectional study on all monthly and quarterly rural telemedicine visits from January 2012 to June 2020, using administrative data from Ontario, Canada. We compared the changes in telemedicine use among residents of rural and urban regions of Ontario prior to and during the pandemic. ResultsBefore the pandemic, telemedicine use was steadily low in 2012-2019 for both rural and urban populations but slightly higher overall for rural patients (11 visits per 1000 patients vs 7 visits per 1000 patients in December 2019, P<.001). The rate of telemedicine visits among rural patients significantly increased to 147 visits per 1000 patients in June 2020. A similar but steeper increase (P=.15) was observed among urban patients (220 visits per 1000 urban patients). Telemedicine use increased across all age groups, with the highest rates reported among older adults aged ≥65 years (77 visits per 100 patients in 2020). The proportions of patients with at least 1 telemedicine visit were similar across the adult age groups (n=82,246/290,401, 28.3% for patients aged 18-49 years, n=79,339/290,401, 27.3% for patients aged 50-64 years, and n=80,833/290,401, 27.8% for patients aged 65-79 years), but lower among younger patients <18 years (n=23,699/290,401, 8.2%) and older patients ≥80 years (n=24,284/290,401, 8.4%) in 2020 (P<.001). There were more female users than male users of telemedicine (n=158,643/290,401, 54.6% vs n=131,758/290,401, 45.4%, respectively, in 2020; P<.001). There was a significantly higher proportion of telemedicine users residing in relatively less rural than in more rural regions (n=261,814/290,401, 90.2% vs n=28,587/290,401, 9.8%, respectively, in 2020; P<.001). ConclusionsTelemedicine adoption increased in rural and remote areas during the COVID-19 pandemic, but its use increased in urban and less rural populations. Future studies should investigate the potential barriers to telemedicine use among rural patients and the impact of rural telemedicine on patient health care utilization and outcomes.https://www.jmir.org/2021/4/e26960 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chu, Cherry Cram, Peter Pang, Andrea Stamenova, Vess Tadrous, Mina Bhatia, R Sacha |
spellingShingle |
Chu, Cherry Cram, Peter Pang, Andrea Stamenova, Vess Tadrous, Mina Bhatia, R Sacha Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study Journal of Medical Internet Research |
author_facet |
Chu, Cherry Cram, Peter Pang, Andrea Stamenova, Vess Tadrous, Mina Bhatia, R Sacha |
author_sort |
Chu, Cherry |
title |
Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study |
title_short |
Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study |
title_full |
Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study |
title_fullStr |
Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study |
title_full_unstemmed |
Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study |
title_sort |
rural telemedicine use before and during the covid-19 pandemic: repeated cross-sectional study |
publisher |
JMIR Publications |
series |
Journal of Medical Internet Research |
issn |
1438-8871 |
publishDate |
2021-04-01 |
description |
BackgroundThe COVID-19 pandemic has led to a notable increase in telemedicine adoption. However, the impact of the pandemic on telemedicine use at a population level in rural and remote settings remains unclear.
ObjectiveThis study aimed to evaluate changes in the rate of telemedicine use among rural populations and identify patient characteristics associated with telemedicine use prior to and during the pandemic.
MethodsWe conducted a repeated cross-sectional study on all monthly and quarterly rural telemedicine visits from January 2012 to June 2020, using administrative data from Ontario, Canada. We compared the changes in telemedicine use among residents of rural and urban regions of Ontario prior to and during the pandemic.
ResultsBefore the pandemic, telemedicine use was steadily low in 2012-2019 for both rural and urban populations but slightly higher overall for rural patients (11 visits per 1000 patients vs 7 visits per 1000 patients in December 2019, P<.001). The rate of telemedicine visits among rural patients significantly increased to 147 visits per 1000 patients in June 2020. A similar but steeper increase (P=.15) was observed among urban patients (220 visits per 1000 urban patients). Telemedicine use increased across all age groups, with the highest rates reported among older adults aged ≥65 years (77 visits per 100 patients in 2020). The proportions of patients with at least 1 telemedicine visit were similar across the adult age groups (n=82,246/290,401, 28.3% for patients aged 18-49 years, n=79,339/290,401, 27.3% for patients aged 50-64 years, and n=80,833/290,401, 27.8% for patients aged 65-79 years), but lower among younger patients <18 years (n=23,699/290,401, 8.2%) and older patients ≥80 years (n=24,284/290,401, 8.4%) in 2020 (P<.001). There were more female users than male users of telemedicine (n=158,643/290,401, 54.6% vs n=131,758/290,401, 45.4%, respectively, in 2020; P<.001). There was a significantly higher proportion of telemedicine users residing in relatively less rural than in more rural regions (n=261,814/290,401, 90.2% vs n=28,587/290,401, 9.8%, respectively, in 2020; P<.001).
ConclusionsTelemedicine adoption increased in rural and remote areas during the COVID-19 pandemic, but its use increased in urban and less rural populations. Future studies should investigate the potential barriers to telemedicine use among rural patients and the impact of rural telemedicine on patient health care utilization and outcomes. |
url |
https://www.jmir.org/2021/4/e26960 |
work_keys_str_mv |
AT chucherry ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy AT crampeter ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy AT pangandrea ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy AT stamenovavess ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy AT tadrousmina ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy AT bhatiarsacha ruraltelemedicineusebeforeandduringthecovid19pandemicrepeatedcrosssectionalstudy |
_version_ |
1721540670526586880 |