Sociodemographic Trends in Telemedicine Visit Completion in Spine Patients During the COVID-19 Pandemic.

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.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1097/brs.0000000000004617

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.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Poehlein

Emily Poehlein

Biostatistician II
Green

Cynthia Lea Green

Associate Professor of Biostatistics & Bioinformatics

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

Erickson

Melissa Maria Erickson

Associate Professor of Orthopaedic Surgery

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.

Goodwin

Courtney Rory Goodwin

Associate Professor of Neurosurgery

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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