ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
Video versus audio telehealth in safety net clinic patients: Changes by rurality and time.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Hybrid care engagement phenotypes and glycemic outcomes in diabetes: a cluster analysis across two health systems.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- Effect of State Medicaid Reimbursement Policies on Telehealth Visits in Community-Based Health Centers.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2026Article
- Continuity of Primary Care in Community Health Centers.Annals of family medicine · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundUnderstanding the mix of video versus audio telehealth modality is critical to informing care for low-income safety net clinic patients. Our study examined whether telehealth modality and continued use of telehealth varied by rurality and whether that changed over time.
methodsEncounters from adults in the OCHIN national network of primary care safety net clinics were identified by encounter type (in-person vs telehealth) and telehealth modality (video vs audio) from 4/1/2021 to 3/31/2023. Our main outcome was an interaction between patient rurality (defined using Rural Urban Commuting Area codes) and time. Linear probability models with clinic fixed effects were used to estimate predicted probabilities.
resultsThe predicted probability of a telehealth visit decreased from 37.9% to 24.7% among urban patients (P <.001) and remained stable (29.5%-29.8%; P = .82) among patients in small rural areas. By March 2023, telehealth use among patients in small rural areas was 5.1 percentage points higher than among urban patients (P = .02). The predicted probability of an audio-only visit ranged from 63.5% to 70.5% for patients across all levels of rurality, but no significant differences by rurality or time were found.
conclusionsSafety net clinic patients were more likely to use audio-only than video telehealth visits. Telehealth in urban and large rural areas decreased since the first year of the pandemic. By the end of the study, patients in small rural communities used significantly more telehealth than urban patients. Elimination of reimbursement for audio telehealth visits may exacerbate existing health care inequities.
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