Telehealth Uptake Among Hispanic People During COVID-19:Retrospective Observational Study

Background: The Hispanic community represents a sizeable community that experiences inequities in the US health care system. As the system has moved toward digital health platforms, evaluating the potential impact on Hispanic communities is critical. Objective: The study aimed to investigate demographic, socioeconomic, and behavioral factors contributing to low telehealth use in Hispanic communities. Methods: We used a retrospective observation study design to examine the study objectives. The COVID-19 ResearchDatabase Consortium provided the Analytics IQ PeopleCore consumer data and Office Alley claims data. The study periodwas from March 2020 to April 2021. Multiple logistic regression was used to determine the odds of using telehealth services. Results: We examined 3,478,287 unique Hispanic patients, 16.6% (577,396) of whom used telehealth. Results suggested thatpatients aged between 18 and 44 years were more likely to use telehealth (odds ratio [OR] 1.07, 95% CI 1.05-1.1; P<.001)than patients aged older than 65 years. Across all age groups, patients with high incomes were at least 20% more likely touse telehealth than patients with lower incomes (P<.001); patients who had a primary care physician (P=.01), exhibited highmedical usage (P<.001), or were interested in exercise (P=.03) were more likely to use telehealth; patients who had unhealthybehaviors such as smoking and alcohol consumption were less likely to use telehealth (P<.001). Male patients were less likelythan female patients to use telehealth among patients aged 65 years and older (OR 0.94, 95% CI 0.93-0.95; P<.001), whilemale patients aged between 18 and 44 years were more likely to use telehealth (OR 1.05, 95% CI 1.03-1.07; P<.001). Amongpatients younger than 65 years, full-time employment was positively associated with telehealth use (P<.001). Patients agedbetween 18 and 44 years with high school or less education were 2% less likely to use telehealth (OR 0.98, 95% CI 0.97-0.99;P=.005). Results also revealed a positive association with using WebMD (WebMD LLC) among patients aged older than 44years (P<.001), while there was a negative association with electronic prescriptions among those who were aged between 18and 44 years (P=.009) and aged between 45 and 64 years (P=.004). Conclusions: This study demonstrates that telehealth use among Hispanic communities is dependent upon factors such as age,gender, education, socioeconomic status, current health care engagement, and health behaviors. To address these challenges,we advocate for interdisciplinary approaches that involve medical professionals, insurance providers, and community-basedservices actively engaging with Hispanic communities and promoting telehealth use. We propose the following recommen-dations: enhance access to health insurance, improve access to primary care providers, and allocate fiscal and educationalresources to support telehealth use. As telehealth increasingly shapes health care delivery, it is vital for professionals tofacilitate the use of all available avenues for accessing care.