The following is a summary of “Equity and Inclusion in Pediatric Gastroenterology Telehealth: A Study of Demographic, Socioeconomic, and Digital Disparities,” published in the September 2023 issue of Pediatrics by Mougey, et al.
For a study, researchers sought to assess and compare pediatric gastroenterology (GI) ambulatory visits conducted in person and via telehealth at the Nemours Children’s Health System in the Delaware Valley (NCH-DV). They focused on evaluating the encounters regarding geospatial, demographic, socioeconomic, and digital disparities.
They analyzed data from 26,565 patient encounters spanning from January 2019 to December 2020. Each participant was associated with U.S. Census Bureau geographic identifiers, which correlated with socioeconomic and digital metrics obtained from the American Community Survey (2015–2019). The reported odds ratios (OR) are expressed as the likelihood of a telehealth encounter versus an in-person encounter.
In 2020, GI telehealth usage at NCH-DV increased 145-fold compared to 2019. When comparing telehealth to in-person usage in 2020, it was found that GI patients requiring a language translator were 2.2 times less likely to opt for telehealth (individual-level adjusted OR [I-ORa] [95% CI, 0.45 [0.30–0.66], P < 0.001). Individuals of Hispanic ethnicity or those of non-Hispanic Black or African American race were 1.3 to 1.4 times less likely to utilize telehealth than non-Hispanic Whites (I-ORa [95% CI], 0.73 [0.59–0.89], P = 0.002 and 0.76 [0.60–0.95], P = 0.02, respectively). Additionally, households in census block groups (BG) that were more inclined to use telehealth were those with broadband access (BG-OR = 2.51 [1.22–5.31], P = 0.014), those above the poverty level (BG-OR = 4.44 [2.00–10.24], P < 0.001), those who owned their own homes (BG-OR = 1.79 [1.25–2.60], P = 0.002), and those with a bachelor’s degree or higher (BG-OR = 6.55 [3.25–13.80], P < 0.001).
The study represented North America’s largest documented pediatric GI telehealth experience, shedding light on racial, ethnic, socioeconomic, and digital disparities. Urgent advocacy and research efforts were needed in pediatric GI to address and rectify telehealth equity and inclusion issues.