Advancing health equity and access using telemedicine: a geospatial assessment

J Am Med Inform Assoc. 2019 Aug 1;26(8-9):796-805. doi: 10.1093/jamia/ocz108.

Abstract

Introduction: Health disparity affects both urban and rural residents, with evidence showing that rural residents have significantly lower health status than urban residents. Health equity is the commitment to reducing disparities in health and in its determinants, including social determinants.

Objective: This article evaluates the reach and context of a virtual urgent care (VUC) program on health equity and accessibility with a focus on the rural underserved population.

Materials and methods: We studied a total of 5343 patient activation records and 2195 unique encounters collected from a VUC during the first 4 quarters of operation. Zip codes served as the analysis unit and geospatial analysis and informatics quantified the results.

Results: The reach and context were assessed using a mean accumulated score based on 11 health equity and accessibility determinants calculated for each zip code. Results were compared among VUC users, North Carolina (NC), rural NC, and urban NC averages.

Conclusions: The study concluded that patients facing inequities from rural areas were enabled better healthcare access by utilizing the VUC. Through geospatial analysis, recommendations are outlined to help improve healthcare access to rural underserved populations.

Keywords: Telemedicine; geospatial; health access; health disparities; social determinates.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Ambulatory Care*
  • Geography, Medical
  • Health Equity*
  • Health Services Accessibility* / statistics & numerical data
  • Healthcare Disparities*
  • Humans
  • North Carolina
  • Rural Health Services
  • Telemedicine*
  • Vulnerable Populations