Sociodemographic Trends in Telemedicine Visit Completion in Spine Patients During the COVID-19 Pandemic.
Date
2023-11
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Abstract
Study design
Retrospective cohort study.Objective
This study identifies potential disparities in telemedicine utilization in the wake of the COVID-19 pandemic and its aftermath in patients receiving spine surgery.Summary of background data
COVID-19 led to the rapid uptake of telemedicine in the spine surgery patient population. While previous studies in other medical subspecialties have identified sociodemographic disparities in telemedicine uptake, this is the first study to identify disparities in patients undergoing spine surgery.Materials and methods
This study included patients who underwent spine surgery between June 12, 2018 and July 19, 2021. Patients were required to have at least one scheduled patient visit, either virtual (video or telephone visit) or in-person. Binary socioeconomic variables used for modeling included: urbanicity, age at the time of the procedure, sex, race, ethnicity, language, primary insurer, and patient portal utilization. Analyses were conducted for the entire cohort and separately for cohorts of patients who had visits scheduled within specific timeframes: Pre-COVID-19 surge, initial COVID-19 surge, and post-COVID-19 surge.Results
After adjusting for all variables in our multivariable analysis, patients who utilized the patient portal had higher odds of completing a video visit compared with those who did not (OR: 5.21; 95% CI: 1.28, 21.23). Hispanic patients (OR: 0.44; 95% CI: 0.2, 0.98) or those living in rural areas (OR: 0.58; 95% CI: 0.36, 0.93) had lower odds of completing a telephone visit. Patients with no insurance or on public insurance had higher odds of completing a virtual visit of either type (OR: 1.88; 95% CI: 1.10, 3.23).Conclusion
This study demonstrates the disparity in telemedicine utilization across different populations within the surgical spine patient population. Surgeons may use this information to guide interventions aimed at reducing existing disparities and work with certain patient populations to find a solution.Type
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Publication Info
Owolo, Edwin, Zoey Petitt, Dana Rowe, Emily Luo, Brandon Bishop, Emily Poehlein, Cynthia L Green, Chad Cook, et al. (2023). Sociodemographic Trends in Telemedicine Visit Completion in Spine Patients During the COVID-19 Pandemic. Spine, 48(21). pp. 1500–1507. 10.1097/brs.0000000000004617 Retrieved from https://hdl.handle.net/10161/31367.
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Scholars@Duke

Emily Poehlein

Cynthia Lea Green
Survival Analysis
Longitudinal Data Analysis
Logistic Regression
Missing Data
Clinical Trial Methods
Maximum Likelihood Methods

Melissa Maria Erickson
I am a spine surgeon who provides surgical management of cervical, thoracic and lumbar spine conditions, including cervical myelopathy, herniated discs, deformity, stenosis, tumor and trauma. I provide both minimally invasive procedures as well as traditional surgical techniques.

Courtney Rory Goodwin
Associate Professor of Neurosurgery, Radiation Oncology, Orthopedic Surgery.
Director of Spine Oncology,
Associate Residency Program Director
Third Year Study Program Director Neurosciences, Duke University School of Medicine
Director of Spine Metastasis, Duke Center for Brain and Spine Metastasis, Department of Neurosurgery
Duke Cancer Institute, Duke University Medical Center
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