Does Telemedicine Transcend Disparities or Create a Digital Divide? Evidence from the COVID-19 Pandemic

23 Pages Posted: 14 May 2021

See all articles by Jeffrey McCullough

Jeffrey McCullough

University of Michigan

Kartik K. Ganju

University of Minnesota

Chandy Ellimoottil

University of Michigan at Ann Arbor - Department of Urology

Date Written: April 26, 2021

Abstract

We examine telemedicine utilization during the COVID-19 pandemic. Advocates have argued that telemedicine can overcome barriers in accessing healthcare and protect patients from contracting COVID-19. Rural and poor patients, for example, would not need to make expensive and time-consuming trips to healthcare facilities when using telemedicine. Conversely, telemedicine adoption may depend on broadband access and technology skills, which could create a digital divide and exacerbate disparities. We study these questions using data on virtual and conventional care from a large commercial insurer. Telemedicine utilization soared during the pandemic. We further find that telemedicine utilization was concentrated in urban and affluent markets. We attribute this to two factors. First, telemedicine use was correlated with broadband penetration. Second, telemedicine adoption was much higher for patients with an established healthcare provider relationship (i.e., received care in the same health system in the previous year). We also find that telemedicine utilization was lower among older patients and comorbidities; cohorts with the greatest risk of severe illness and death from COVID-19. Without further intervention, telemedicine could exacerbate existing health care disparities.

Note: Funding Statement: None of the authors have any sources of funding.

Declaration of Interests: None of the authors have any competing interests to declare.

Ethics Approval Statement: The University of Michigan IRB determined IRB approval was not required as the data cannot be tracked to a human subject, HUM00191241. The McGill Research Ethic Board approved this research, 21-05-026.

Keywords: Healthcare Disparities, Telemedicine, COVID-19 pandemic, Digital Divide, Healthcare IT

JEL Classification: I14

Suggested Citation

McCullough, Jeffrey and Ganju, Kartik K. and Ellimoottil, Chandy, Does Telemedicine Transcend Disparities or Create a Digital Divide? Evidence from the COVID-19 Pandemic (April 26, 2021). Available at SSRN: https://ssrn.com/abstract=3834445 or http://dx.doi.org/10.2139/ssrn.3834445

Jeffrey McCullough

University of Michigan ( email )

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HOME PAGE: http://https://sph.umich.edu/faculty-profiles/mccullough-jeffrey.html

Kartik K. Ganju (Contact Author)

University of Minnesota ( email )

United States

Chandy Ellimoottil

University of Michigan at Ann Arbor - Department of Urology ( email )

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