Abstract
INTRODUCTION: The COVID-19 pandemic rapidly expanded telehealth services when in-person care was limited. Using primary care data from a large federally qualified health center in Washington state, this study aimed to: 1) describe trends in telehealth use among adult patients, and 2) provide disaggregated patient characteristic data associated with telehealth use, with a focus on patients speaking Asian Indian languages. METHODS: The authors conducted a retrospective cross-sectional study using electronic health data from adult patients seen at the partner health center between January 1, 2020 and December 31, 2022. Multivariable logistic models for each year generated adjusted odds ratios and 95% confidence intervals for characteristics associated with completing a telehealth visit (video or phone). A subgroup analysis on telehealth use among patients speaking languages commonly spoken in India was also completed. RESULTS: The study included 653,378 primary care encounters from 127,146 unique adults (mean age 50; 56% female; nearly one-third Hispanic or Latino). Top 5 languages spoken were English, Spanish, Russian, Punjabi, and Vietnamese. Telehealth use peaked in 2020 and declined in subsequent years, while in-person visits were highest in 2021. Lower odds of telehealth use associated with being younger, identifying as a racial or ethnic minority, preferring a language other than English, residing in a rural county, identifying as male or Gender X, and lacking insurance. DISCUSSION: The findings highlighted disparities in telehealth use across demographic and linguistic lines, including among Asian Indian language speakers, echoing concerns of inequitable access. CONCLUSION: Findings can guide strategies to improve telehealth services for underrepresented groups.