About: Telemedicine and Outpatient Subspecialty Visits among Pediatric Medicaid Beneficiaries

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Telemedicine and Outpatient Subspecialty Visits among Pediatric Medicaid Beneficiaries
Creator	Kahn, Jeremy Mehrotra, Ateev Ray, Kristin Yabes, Jonathan
source	Elsevier; Medline; PMC
abstract	OBJECTIVE: Live-interactive telemedicine is increasingly covered by state Medicaid programs, but whether telemedicine is improving equity in utilization of subspecialty care is not known. We examined patterns of telemedicine use for outpatient pediatric subspecialty care within state Medicaid programs. METHODS: We identified children ≤17 years old in 2014 Medicaid Analysis eXtract data for 12 states. We identified telemedicine-using and telemedicine non-using medical and surgical subspecialists. Among children cared for by telemedicine-using subspecialists, we assessed child and subspecialist characteristics associated with any telemedicine visit using logistic regression with subspecialist-level random effects. Among children cared for by telemedicine-using and non-using subspecialists, we compared visit rates across child characteristics by assessing negative binomial regression interaction terms. RESULTS: Of 12,237,770 pediatric Medicaid beneficiaries, 2,051,690 (16.8%) had ≥1 subspecialist visit. Of 42,695 subspecialists identified, 146 (0.3%) had ≥1 telemedicine claim. Among children receiving care from telemedicine-using subspecialists, likelihood of any telemedicine use was increased for rural children (OR 10.4, 95%CI 6.3-17.1 compared to large metropolitan referent group) and those >90 miles from the subspecialist (OR 13.4, 95% CI 10.2-17.7 compared to 0-30 mile referent group). Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger differences in visit rates by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for interaction terms). CONCLUSION: Children in rural communities and at distance to subspecialists had increased likelihood of telemedicine use. Use overall was low, and results indicated that early telemedicine policies and implementation did not close disparities in subspecialty visit rates by child geographic and sociodemographic characteristics.
has issue date	2020-04-08(xsd:dateTime)
bibo:doi	10.1016/j.acap.2020.03.014
bibo:pmid	32278078
has license	no-cc
sha1sum (hex)	1db68d4b870afb643cfc25ac7ca70c0b9bd684ad
schema:url	https://doi.org/10.1016/j.acap.2020.03.014
resource representing a document's title	Telemedicine and Outpatient Subspecialty Visits among Pediatric Medicaid Beneficiaries
has PubMed Central identifier	PMC7194998
has PubMed identifier	32278078
schema:publication	Acad Pediatr
resource representing a document's body	covid:1db68d4b870afb643cfc25ac7ca70c0b9bd684ad#body_text
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