Patients report unmet care needs despite rising telehealth use


When soaring Covid-19 cases hampered many practices’ ability to see patients in-person, telehealth has served as a critical tool to help people access care. But it hasn’t worked for everyone.

Some people were unable to access the care they needed because it couldn’t be conducted through telehealth, or because they couldn’t access their provider, according to a survey conducted by the Urban Institute and funded by the Robert Wood Johnson Foundation.

Roughly a third of adults had a telehealth visit in the first six months of the pandemic, according to the survey, which was conducted in September.

But of the 4,000 people surveyed, 6% said they had wanted a telehealth visit, but had not yet had one since the start of the pandemic. People who reported having multiple chronic conditions, or fair or poor health, were significantly more likely to have been unable to access a virtual appointment that they wanted.

The survey also highlighted racial disparities in telehealth access. Significantly more Black and Latinx respondents said they wanted a telehealth visit but were not able to get one than white adults.

The top cited reasons for not being able to access care included waiting too long to get an appointment (27%) and needing a treatment, test or medication that could only be provided in person (27%). But a significant number of patients also said their provider was not taking phone or video visits (22%), that they didn’t have the needed technology for these types of visits (17%) or that their visit would not be covered by health insurance (15%).

Another portion of adults missed care because their provider was only taking telehealth visits, and they wanted an in-person visit. Roughly 8% of all survey respondents encountered this problem. More adults with public health insurance coverage, or with fair or poor health, reported not having a visit for this reason.

By far, the most commonly cited reason was that the care they needed could only be provided in person (45.9%), but respondents also cited not being comfortable using the required technology (33%) and privacy concerns (13.4%).

“This analysis shows unmet needs for healthcare still exist for some as a result of the pandemic – and continued reliance on telehealth could exacerbate existing health inequities,” Laura Smith, a research associate at the Urban Institute, said in a news release.

Those who did access telehealth in the last six months were more likely to live in metro areas than rural areas. Black and Latinx adults were also slightly more likely to have used telehealth than white adults.

But the biggest differentiator was people’s health. For example, 54% of people who had multiple chronic conditions reported having a telehealth visit during the pandemic, compared to 21% of people who reported having none.

It’s not surprising that people who reported having one or more health conditions would seek out a virtual appointment during a pandemic. The problem is when they can’t access care.

“As the pandemic stretches on, it is important to ensure that everyone can access needed care,” Mona Shah, a senior program officer at the Robert Wood Johnson Foundation, said in a news release. “Those left behind by telehealth are, in many cases, people who need care most urgently.”

Photo credit: Venimo, Getty Images

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