Telehealth use among pediatric Alabama Medicaid enrollees, March-December 2020: Variations by race/ethnicity & place of residence

PLoS One. 2023 Jun 26;18(6):e0287598. doi: 10.1371/journal.pone.0287598. eCollection 2023.

Abstract

During the early days and months of the COVID-19 pandemic, healthcare facilities experienced a slump in non-COVID-related visits, and there was an increasing interest in telehealth to deliver healthcare services for adult and pediatric patients. The study investigated telehealth use variation by race/ethnicity and place of residence for the pediatric enrollees of the Alabama Medicaid program. This retrospective observational study examined Alabama Medicaid claims data from March to December 2020 for enrollees less than 19 years. There were 637,792 pediatric enrollees in the Alabama Medicaid program during the study period, and 16.9% of them had used telehealth to meet healthcare needs. This study employed a multivariate Poisson mixed-effects model with robust error variance to obtain differences in telehealth utilization and found that Non-Hispanic Black children were 80% as likely, Hispanic children were 55% as likely, and Asian Children were 46% as likely to have used telehealth compared to Non-Hispanic White children. Pediatric enrollees in large rural areas and isolated areas were significantly less likely (IRR: 0.90 for both, p<0.05) to use telehealth than those in urban areas. This study's findings suggest that attention needs to be paid to addressing race/ethnicity disparities in accessing telehealth services.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alabama
  • COVID-19* / epidemiology
  • Child
  • Ethnicity
  • Health Services Accessibility
  • Humans
  • Medicaid
  • Pandemics
  • Residence Characteristics
  • Telemedicine*
  • United States

Grants and funding

This study was funded in part by the Alabama Medicaid Agency (https://medicaid.alabama.gov/), contract number: C200629944. BS is the principal investigator of the award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.