Is Telemedicine Closing the ‘Race Gap’ in Primary Care?

Here’s one way in which the pandemic did not exacerbate health care disparities: A new study shows that telemedicine has closed the gap in access to primary care between Black and non-Black Americans.

The use of telemedicine boomed during the pandemic, so University of Pennsylvania researchers decided to examine how that affected Black patients’ historically lower access to primary care.

“We looked through the entire year of 2020, not just the first half of the year when telemedicine was the only option for many people, and the appointment completion gap between Black and non-Black patients closed,” said study senior author Dr. Krisda Chaiyachati, an assistant professor of medicine at Penn Medicine.

“Offering telemedicine, even though it was for a crisis, appears to have been a significant step forward toward addressing long-standing inequities in health care access,” he said in a university news release.

The researchers analyzed data on visits by Black and non-Black patients (predominately whites) to primary care providers in the Philadelphia area in 2019 and 2020. The study included about 1 million appointments each year.

Rates of completed primary care visits among Black patients rose from about 60% in 2019 to more than 80% in 2020, while rates among non-Blacks rose from about 70% to more than 80%.

“The specific time periods where we saw significant gains made by Black patients came when telemedicine was well-established in our health system,” Chaiyachati said. “This does not appear to be a coincidence.”

Black patients were more likely to use telemedicine than non-Black patients. In 2020, about 33% of Black patients’ appointments were completed via telemedicine, compared with 25% for non-Black patients, according to the findings.

The study was published recently in the journal Telemedicine and e-Health.

“Telemedicine allowed patients to seek non-urgent primary care despite hesitancy for in-person visits pre-vaccine,” noted study co-author Dr. Corinne Rhodes, an assistant professor of internal medicine and assistant medical director of Quality in Penn Medicine’s Primary Care Service Line.

“Providing chronic disease management and preventive care helped return primary care offices closer to pre-pandemic business as usual,” she said in the release.

There were concerns at the start of the pandemic that telemedicine might widen the racial gap in access to care, but this study adds to evidence that was not the case for primary care.

“As the health care sector — policymakers, payers, providers and patients — continue to develop the role telemedicine may play in health care’s future, understanding how it can be a mechanism for improving equity is an important dimension to consider,” Chaiyachati said.

More information

There’s more on telemedicine at the American Academy of Family Physicians.

SOURCE: University of Pennsylvania, news release, May 9, 2022

Source: HealthDay