Telehealth Use Among Adultswith Sickle Cell Disease in Texas Medicaid Before and During the Covid-19 Pandemic
Author(s)
Pin Hsuan Liao, BS Pharm1, Hyeun Ah KANG, MEd, MS, RPh, PhD1, Courtney Miller-Chism, MD2, Kenneth Lawson, BS, MS, PhD1;
1The University of Texas at Austin, College of Pharmacy, Austin, TX, USA, 2Baylor College of Medicine, Medicine-Hematology & Oncology, Houston, TX, USA
1The University of Texas at Austin, College of Pharmacy, Austin, TX, USA, 2Baylor College of Medicine, Medicine-Hematology & Oncology, Houston, TX, USA
Presentation Documents
OBJECTIVES: Individuals with sickle cell disease (SCD) frequently face barriers to accessing care, which is associated with poor health outcomes. While telehealth emerged as an alternative care delivery method during the COVID-19 pandemic, its utilization patterns among adult Medicaid beneficiaries with SCD remain unknown. This study aims to: 1) examine telehealth use patterns before and during the COVID-19 pandemic; and 2) identify factors associated with telehealth adoption among adult Medicaid beneficiaries with SCD in Texas.
METHODS: This retrospective study analyzed Texas Medicaid claims from 03/2019 to 03/2022. Adults aged 18-62 years with ≥3 SCD diagnoses, no cancer diagnosis, and continuous enrollment throughout the study period were included. For objective 1, monthly telehealth utilization was assessed. For objective 2, multivariable logistic regression was conducted to determine the associations between telehealth use during the first year of the pandemic (03/2020-02/2021) and patients’ sociodemographic characteristics (age, sex, geographic region) and pre-pandemic healthcare utilization.
RESULTS: Among the included 546 beneficiaries (mean [SD] age=34.3 [11.5]), 386 (70.7%) utilized telehealth services during the pandemic. Prior to 03/2020, telehealth visits were less than 0.3 % of total visits, but increased substantially post-pandemic, peaking at 4.8% in the second quarter of 2020. Multivariable analysis revealed that patients with high pre-pandemic healthcare utilization (≥10 outpatient visits) were more likely to adopt telehealth compared to those with lower utilization (0-4 visits) (OR=2.17, 95% CI: 1.39-3.37, p=0.0006). Residents of major Texas metropolitan areas (Houston, Dallas, Fort Worth, Austin, San Antonio) showed significantly higher telehealth adoption compared to non-metropolitan areas (OR=2.14, 95% CI: 1.46-3.12, p<0.0001).
CONCLUSIONS: Telehealth adoption among adult Medicaid beneficiaries with SCD in Texas increased substantially during the COVID-19 pandemic. Patients with higher pre-pandemic healthcare utilization and those residing in metropolitan areas were more likely to engage in telehealth services, suggesting geographic healthcare access disparities remain in telehealth adoption among this population.
METHODS: This retrospective study analyzed Texas Medicaid claims from 03/2019 to 03/2022. Adults aged 18-62 years with ≥3 SCD diagnoses, no cancer diagnosis, and continuous enrollment throughout the study period were included. For objective 1, monthly telehealth utilization was assessed. For objective 2, multivariable logistic regression was conducted to determine the associations between telehealth use during the first year of the pandemic (03/2020-02/2021) and patients’ sociodemographic characteristics (age, sex, geographic region) and pre-pandemic healthcare utilization.
RESULTS: Among the included 546 beneficiaries (mean [SD] age=34.3 [11.5]), 386 (70.7%) utilized telehealth services during the pandemic. Prior to 03/2020, telehealth visits were less than 0.3 % of total visits, but increased substantially post-pandemic, peaking at 4.8% in the second quarter of 2020. Multivariable analysis revealed that patients with high pre-pandemic healthcare utilization (≥10 outpatient visits) were more likely to adopt telehealth compared to those with lower utilization (0-4 visits) (OR=2.17, 95% CI: 1.39-3.37, p=0.0006). Residents of major Texas metropolitan areas (Houston, Dallas, Fort Worth, Austin, San Antonio) showed significantly higher telehealth adoption compared to non-metropolitan areas (OR=2.14, 95% CI: 1.46-3.12, p<0.0001).
CONCLUSIONS: Telehealth adoption among adult Medicaid beneficiaries with SCD in Texas increased substantially during the COVID-19 pandemic. Patients with higher pre-pandemic healthcare utilization and those residing in metropolitan areas were more likely to engage in telehealth services, suggesting geographic healthcare access disparities remain in telehealth adoption among this population.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD65
Topic
Health Service Delivery & Process of Care
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)