@article {1615215,
	title = {Association of Patient Characteristics With Delivery of Ophthalmic Telemedicine During the COVID-19 Pandemic},
	journal = {JAMA Ophthalmol},
	volume = {139},
	number = {11},
	year = {2021},
	month = {2021 11 01},
	pages = {1174-1182},
	abstract = {Importance: Telemedicine has been shown to have had reduced uptake among historically marginalized populations within multiple medical specialties during the COVID-19 pandemic. An evaluation of health disparities among patients receiving ophthalmic telemedical care during the pandemic is needed. Objective: To evaluate disparities in the delivery of ophthalmic telemedicine at Massachusetts Eye and Ear (MEE) during the COVID-19 pandemic. Design, Setting, and Participants: This retrospective, cross-sectional study analyzed clinical visits at a single tertiary eye care center (MEE) from January 1 to December 31, 2020. Patients who had ophthalmology and optometry clinical visits at the MEE during the study period were included. Exposures: Telemedicine vs in-person clinical encounters. Main Outcomes and Measures: Variables associated with use of ophthalmic telemedicine during the study period. Results: A total of 2262 telemedicine ophthalmic encounters for 1911 patients were included in the analysis. The median age of the patients was 61 (interquartile range, 43-72) years, and 1179 (61.70\%) were women. With regard to race and ethnicity, 87 patients (4.55\%) identified as Asian; 128 (6.70\%), as Black or African American; 23 (1.20\%), as Hispanic or Latino; and 1455 (76.14\%), as White. On multivariate analysis, factors associated with decreased receipt of telemedical care included male sex (odds ratio [OR], 0.86; 95\% CI, 0.77-0.96), Black race (OR, 0.69; 95\% CI, 0.56-0.86), not speaking English (OR, 0.63; 95\% CI, 0.48-0.81), educational level of high school or less (OR, 0.83; 95\% CI, 0.71-0.97), and age (OR per year of age, 0.99; 95\% CI, 0.989-0.998). When comparing telephone- and video-based telemedicine visits, decreased participation in video-based visits was associated with age (OR per year of age, 0.96; 95\% CI, 0.94-0.98), educational level of high school or less (OR, 0.54; 95\% CI, 0.29-0.99), being unemployed (OR, 0.28; 95\% CI, 0.12-0.68), being retired (OR, 0.22; 95\% CI, 0.10-0.42), or having a disability (OR, 0.09; 95\% CI, 0.04-0.23). Conclusions and Relevance: The findings of this cross-sectional study, though limited to retrospective data from a single university-based practice, suggest that historically marginalized populations were less likely to receive ophthalmic telemedical care compared with in-person care during the first year of the COVID-19 pandemic in the US. Understanding the causes of these disparities might help those who need access to virtual care.},
	issn = {2168-6173},
	doi = {10.1001/jamaophthalmol.2021.3728},
	author = {Aziz, Kanza and Moon, Jade Y and Parikh, Ravi and Lorch, Alice C and Friedman, David S and Miller, John B and Armstrong, Grayson W}
}
