@Article{info:doi/10.2196/25873,
author="Khairat, Saif
and McDaniel, Phillip
and Jansen, Matthew
and Francis, Tia
and Edson, Barbara
and Gianforcaro, Robert",
title="Analysis of Social Determinants and the Utilization of Pediatric Tele--Urgent Care During the COVID-19 Pandemic: Cross-sectional Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Aug",
day="30",
volume="4",
number="3",
pages="e25873",
keywords="telehealth; pediatrics; social; determinants; COVID-19; use; children; infant; consultation; telemedicine; urgent care; vulnerable population; cross-sectional; minority",
abstract="Background: Telehealth is increasingly used to provide specialty consultations to infants and children receiving care. However, there is uncertainty if the COVID-19 pandemic has influenced the use of telehealth among vulnerable populations. Objective: This research aims to compare the overall use of tele--urgent care visits for pediatric patients before and after the pandemic, especially among vulnerable populations. Methods: We conducted a cross-sectional analysis of pediatric tele--urgent care visits at a virtual care center at a southeastern health care center. The main outcome of this study was the use of pediatrics tele--urgent visits across geographical regions with different levels of social disparities and between 2019 and 2020. Results: Of 584 tele--urgent care visits, 388 (66.4{\%}) visits occurred in 2020 during the pandemic compared to 196 (33.6{\%}) visits in 2019. Among 808 North Carolina zip codes, 181 (22{\%}) consisted of a high concentration of vulnerable populations, where 17.7{\%} (56/317) of the tele--urgent care visits originated from. The majority (215/317, 67.8{\%}) of tele--urgent care visits originated from zip codes with a low concentration of vulnerable populations. There was a significant association between the rate of COVID-19 cases and the concentration level of social factors in a given Zip Code Tabulation Area. Conclusions: The use of tele--urgent care visits for pediatric care doubled during the COVID-19 pandemic. The majority of the tele--urgent care visits after COVID-19 originated from regions where there is a low presence of vulnerable populations. In addition, our geospatial analysis found that geographic regions with a high concentration of vulnerable populations had a significantly higher rate of COVID-19--confirmed cases and deaths compared to regions with a low concentration of vulnerable populations. ",
issn="2561-6722",
doi="10.2196/25873",
url="https://pediatrics.jmir.org/2021/3/e25873",
url="https://doi.org/10.2196/25873",
url="http://www.ncbi.nlm.nih.gov/pubmed/34459742"
}