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Sociodemographic Factors Affecting Telemedicine Access: A Population-Based Analysis
Anees B. Chagpar
Yale University, New Haven, CT

OBJECTIVE: The COVID pandemic prompted a surge in telemedicine. This rests on the presumption that patients have computer and internet access. We sought to determine, in a population-based sample, how many Americans had such access prior to the pandemic, and whether certain groups were more at risk.METHODS: The National Health Interview Survey is conducted annually by the CDC, and is designed to be representative of the entire civilian non-institutionalized population in the US. In 2018, they fielded a number of questions regarding computer and web access. We evaluated sociodemographic factors associated with access using SAS-callable SUDAAN software.RESULTS: 25,049 people, representing 245,842,992 in the population, responded to these questions. 19% stated they used a computer “never or almost never”. 18% stated they did not use the internet, and 25% stated they did not use email. Over the previous 12 months, 55% stated they had looked up health information on the internet, 11% had filled a prescription online, 16% had scheduled a medical appointment on the internet, and 17% had communicated with a healthcare provider by email. Internet usage varied by region, age, race, education, family income, and insurance status, but not by gender (see table). CONCLUSION: As telemedicine continues to become more prevalent, it is critical to be cognizant of sociodemographic factors that may disadvantage certain segments of the population for whom computer and internet access is an issue.


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