Disparities in Telemedicine Satisfaction Among Older and Non-White Dermatology Patients: A Cross-Sectional Study

February 2022 | Volume 21 | Issue 2 | Editorials | 210 | Copyright © February 2022


Published online January 31, 2022

Michelle J. Chang BA,a Shari R. Lipner MD PhDb

aDrexel University, Philadelphia, PA
bWeill Cornell Medicine, New York, NY

Abstract
Telemedicine use has expanded rapidly during the COVID-19 pandemic. There is limited data on patient satisfaction with teledermatology; therefore, we examined patient teledermatology experiences at a large academic center.

INTRODUCTION

Telemedicine use has expanded rapidly during the COVID-19 pandemic. There is limited data on patient satisfaction with teledermatology; therefore, we examined patient teledermatology experiences at a large academic center.

After Weill Cornell Medicine Institutional Review Board approval, patients scheduled for teledermatology visits (1/2021–4/2021) were enrolled and sent pre/post-consultation questionnaires about telemedicine satisfaction, expectations, and concerns (5-point Likert scale) (82% response rate). Continuous outcomes were reported as means and categorical outcomes as percentages. Fisher’s exact and Chi-squared tests compared responses based on gender, age group, race, and clinic distance, respectively. Identical pre/post-consultation questions were compared with Wilcoxon signed-rank test (P<0.5).

Of 202 participants, 120 (59%) were female with mean age 49 years. Participants were largely White (78%) and non-Hispanic (86%). The majority had at least a college degree (94%) and were employed (66%; Supplemental Table 1).

Younger patients (21-40) were more satisfied with telemedicine (P=.016), and its convenience (P=.001), compared to older participants (≥66; P=.001, P=.019). Those with shorter travel times (<30min) preferred in-person visits (P=.031; Table 1). Non-White race was associated with greater concerns for conversation privacy and inappropriate information access (both P=.004). White race was associated with greater confidence in telemedicine diagnosis (P=.032; Figure 1).

Participants had less trouble hearing and seeing than anticipated (P=<.001 and P=.005). Patients were more interested in using telemedicine and preferred it over in-person appointments post vs pre-consultation (P<.001 both; Supplemental Table 2).