Document Type
Article
Publication Date
9-1-2023
Identifier
DOI: 10.1097/MPG.0000000000003797; PMCID: PMC10412077
Abstract
OBJECTIVES: The purpose of our study is to compare in-person and telehealth pediatric care ambulatory visits for gastroenterology (GI) at the Nemours Children's Health System in the Delaware Valley (NCH-DV) based on geospatial, demographic, socioeconomic, and digital disparities.
METHODS: Characteristics of 26,565 patient encounters from January 2019 to December 2020 were analyzed. U.S. Census Bureau geographic identifiers were assigned to each participant and aligned with the American Community Survey (2015-2019) socioeconomic and digital outcomes. Reported odds ratios (OR) are telehealth encounter/in-person encounter.
RESULTS: GI telehealth usage increased 145-fold in 2020 compared to 2019 for NCH-DV. Comparing telehealth to in-person usage in 2020 revealed that GI patients who required a language translator were 2.2-fold less likely to choose telehealth [individual level adjusted OR (I-OR a ) [95% confidence interval, CI], 0.45 [0.30-0.66], P < 0.001]. Individuals of Hispanic ethnicity or non-Hispanic Black or African American race are 1.3-1.4-fold less likely to utilize telehealth than non-Hispanic Whites (I-OR a [95% CI], 0.73 [0.59-0.89], P = 0.002 and 0.76 [0.60-0.95], P = 0.02, respectively). Households in census block groups (BG) that are more likely to utilize telehealth: have broadband access (BG-OR = 2.51 [1.22-5.31], P = 0.014); are above the poverty level (BG-OR = 4.44 [2.00-10.24], P < 0.001); own their own home (BG-OR = 1.79 [1.25-2.60], P = 0.002); and have a bachelor's degree or higher (BG-OR = 6.55 [3.25-13.80], P < 0.001).
CONCLUSIONS: Our study is the largest reported pediatric GI telehealth experience in North America that describes racial, ethnic, socioeconomic, and digital inequities. Advocacy and research for pediatric GI focused on telehealth equity and inclusion is urgently needed.
Journal Title
Journal of pediatric gastroenterology and nutrition
Volume
77
Issue
3
First Page
319
Last Page
326
MeSH Keywords
Child; Humans; Ethnicity; Gastroenterology; Hispanic or Latino; Poverty; Telemedicine; Black or African American; White; Healthcare Disparities
Keywords
Ethnicity; Gastroenterology; Hispanic or Latino; Poverty; Telemedicine; Black or African American; White; Healthcare Disparities
Recommended Citation
Mougey EB, Judy WC, Venkatesh RD, et al. Equity and Inclusion in Pediatric Gastroenterology Telehealth: A Study of Demographic, Socioeconomic, and Digital Disparities. J Pediatr Gastroenterol Nutr. 2023;77(3):319-326. doi:10.1097/MPG.0000000000003797
Comments
This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Publisher's Link: https://journals.lww.com/jpgn/fulltext/2023/09000/equity_and_inclusion_in_pediatric_gastroenterology.3.aspx