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UPJ INSIGHT: Predictors of Video versus Audio-Only Telehealth Use among Urological Patients

By: Erica Jaiyeola Odukoya, MPH; Juan Andino, MD, MBA; Sophia Ng, PhD; Emma Steppe, MPH; Chad Ellimoottil, MD, MS | Posted on: 01 Jun 2022

Odukoya EJ, Andino J, Ng S et al: Predictors of video versus audio-only telehealth use among urological patients. Urol Pract 2022; 9: 198.

Study Needs and Importance

During the COVID-19 public health emergency, telehealth use had grown due to regulatory and reimbursement changes that facilitated the use of video and audio-only visits for the evaluation and management of patients.

What We Found

We identified 7,851 unique patients who had a urological outpatient visit. Demographic factors associated with lower probability of utilizing video telehealth were older age (19–64 years and ages ≥65 years, average marginal effect [AME] −11.7 95% CI −14.9, −9.4 and AME −38.3 95% CI −40.8, −34.7, respectively), Black/African American race, and American Indian and Alaska Native race (AME −9.7, 95% CI −10.7, −7.1; and AME −17.1, 95% CI −18.8, −13.7, respectively), interpreter use (AME −4.5, 95% CI −5, −3.1), Medicaid insurance (AME −13.3, 95% CI −14.8, −9.8), rural residence (by zip code) and living in an area with low broadband access (lowest broadband access quartile AME −12.8, 95% CI −14.1, −9.1; reference highest broadband access quartile).

“These data suggest that without coverage and reimbursement of phone visits, video-only telehealth could exacerbate health disparities in access to urological care.”

Limitations

The main limitation is that our study analyzed data at a single center.

Interpretation for Patient Care

Of the patients who used telehealth during the early months of the pandemic 44% used audio-only visits to connect with their urologists. Patients who were older, identified as African American or Hispanic, lived in a rural area, utilized public insurance or reported lower access to broadband Internet had a decreased probability of using video to receive urological care. These data suggest that without coverage and reimbursement of phone visits, video-only telehealth could exacerbate health disparities in access to urological care.