Telemedicine Use by Seniors Rises, but Remains Low

(Reuters Health) – During the pandemic, telemedicine use among seniors rose five-fold, but most seniors continued to see their physicians in person, a new study finds.

Survey responses from a sample of Medicare enrollees revealed that their telemedicine use rose from 5.4% to 23.9%, while 59.9% saw their doctors in person, according to the report published in the Annals of Internal Medicine.

“Telemedicine use among older adults increased 5-fold during the pandemic, yet only one quarter of adults used video visits and about a half went to see their healthcare provider in person despite risks during the pandemic,” said the study’s first author, Dr. Julia L. Frydman of the Brookdale Department of Geriatrics and Palliative medicine at the Icahn School of Medicine in New York. “Those with lower educational attainment, without a spouse or partner, and living in rural areas were less likely to use telemedicine. This work suggests that older adults who would benefit from telemedicine services may be unable to access these services.”

“Telemedicine has the potential to improve access to care for older adults across socioeconomic status but will require thoughtfully designed interventions to ensure that those older adults who would benefit from telemedicine can access services,” Dr. Frydman said in an email.

Getting more seniors to use telemedicine will require a multifaceted approach to overcome the digital divide, Dr. Frydman said. Potential strategies, she suggested, including tailoring the user experience to the needs of older adults, providing community-based technical support, and improving seniors’ access to internet-enabled devices and to broadband internet.

The researchers gathered survey respondents’ sociodemographic and clinical characteristics from the 2019 National Health and Aging Trends Study (NHATS), a longitudinal study of Medicare enrollees. Respondents were subsequently mailed additional questions about telemedicine use between June and October 2020. Of the 3,961 respondents who received the supplement, 2,350 answered the telemedicine use questions.

Most of those who answered, 53.4%, were female, while 81.8% lived in metro areas.

The researchers used multivariable logistic regression to assess marginally adjusted proportions and adjusted proportion ratios (APRs).

People were less likely to use telemedicine if they lived in a nonmetropolitan area (APR, 0.80), had an education level of high school or less (APR, 0.71), had no spouse or partner (APR, 0.83), had no prepandemic telemedicine use (APR, 0.16) and had made in-person visits during the pandemic (APR, 0.82).

“This study provides a brief look at who telemedicine isn’t reaching: rural populations, those without a spouse or partner, and those with less education, said Abigail Greenleaf, an assistant professor at ICAP at the Columbia University Mailman School of Public Health.

“Older adults, who, for myriad reasons, have more challenges getting to in-person appointments than younger counterparts, particularly stand to benefit from expanded telemedicine access,” Greenleaf said in an email. “Centering questions of inequities, as this study did, will help ensure all older adults benefit from this technology. Better understanding video telemedicine use among older adults will benefit their health long beyond the pandemic.”

SOURCE: Annals of Internal Medicine, online November 8, 2021.

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