ArticleJMIR pediatrics and parenting2024
Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study.
Article in JMIR pediatrics and parenting, 2024. 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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3 citing papers in PubMed.
- Location of Crisis Service Delivery for Medicaid-Enrolled Youths With Behavioral Health Conditions.Psychiatric services (Washington, D.C.) · 2026Article
- Feasibility, Diagnostic Accuracy, and Satisfaction of an Acute Pediatric Video Interconsultation Model in Rural Primary Care in Catalonia: Prospective Observational Study.JMIR pediatrics and parenting · 2026Article
- Telemedicine for new immigrant children in the US: a tool for equity or another layer of disparity?Frontiers in pediatrics · 2026Review
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSince the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community over a sustained period has yet to be described.
objectiveWe aimed to assess the relationship between demographics, patient portal activation, and telemedicine visits, as well as characterize diagnoses addressed in telemedicine, in a low-income, primarily Latino population over time.
methodsA multidisciplinary team conducted outreach for telemedicine and patient portal activation with the adoption of a new electronic health record. Data were collected on all in-person and telemedicine visits from February 2020 through April 2021 for 4 community-based pediatric practices. The outcomes included patient portal activation, telemedicine use, and reason for telemedicine visits. Bivariate tests and multivariate regression analyses were conducted to assess the independent effects of demographics on the likelihood of portal activation and having a telemedicine visit. Telemedicine diagnoses were categorized, and subanalyses were conducted to explore variations by age and month.
resultsThere were 12,377 unique patients and 7127 telemedicine visits. Latino patients made up 83.4% (n=8959) of the population. Nearly all patients (n=10,830, 87.5%) had an activated portal, and 33.8% (n=4169) had at least 1 telemedicine visit. Portal activation decreased with age >2 years (2-4 years: adjusted odds ratio [aOR] 0.62, 95% CI 0.51-0.76; 5-11 years: aOR 0.28, 95% CI 0.23-0.32; 12-14 years: aOR 0.29, 95% CI 0.23-0.35; and 15-17 years: aOR 0.46, 95% CI 0.36-0.58). Spanish-speaking (aOR 0.52, 95% CI 0.45-0.59) and non-Latino patients (aOR 0.64, 95% CI 0.54-0.76) had decreased odds of activation and having a telemedicine visit (aOR 0.81, 95% CI 0.74-0.89 and aOR 0.71, 95% CI 0.62-0.81, respectively). The top 5 diagnostic categories for telemedicine were infectious disease (n=1749, 26.1%), dermatology (n=1287, 19.5%), gastrointestinal (n=771, 11.7%), well and follow-up care (n=459, 7%), and other specialty-related care (n=415, 6.3%). Infectious disease showed the most variation over time. Age-based patterns included a decrease in the proportion of infectious disease diagnoses by increasing age group and a higher proportion of well and follow-up care in older ages. Additional telemedicine diagnoses included common infant concerns for patients younger than 2 years of age; pulmonary, asthma, and allergy concerns for toddler or school-age children; behavioral health concerns for younger adolescents; and genitourinary and gynecologic concerns for older adolescents.
conclusionsThe high engagement across demographics suggests feasibility and interest in telemedicine in this low-income, primarily Latino population, which may be attributable to the strength of outreach. Language-based disparities were still present. Telemedicine was used for a wide range of diagnoses. As telemedicine remains a vital component of pediatric health care, targeted interventions may enhance engagement to serve diverse pediatric patient populations.
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