| Institution: | 1. Division of Pediatric General and Thoracic Surgery, Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA;2. University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA;3. Department of Otolaryngology, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195, USA;4. Children''s Core for Biomedical Statistics, Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle WA 98105, USA;5. Division of Urology, Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States;6. Division of Transplant Surgery, Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States;7. Division of Pediatric Otolaryngology, Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA |
| Abstract: | BackgroundRecent studies have described the use of telehealth for pediatric surgical care during the COVID-19 pandemic. We aimed to evaluate equity in telehealth use by comparing rates of utilization and satisfaction with pediatric surgical telemedicine among Hispanic patients.MethodsWe conducted a retrospective cohort study of patients seen by a surgical subspecialty provider in the outpatient setting at a quaternary pediatric hospital between April 1 and June 30, 2020. Patients evaluated in the same three-month period in 2019 were analyzed as a historic control. Differences in Family Experience Survey (FES) responses based on race and ethnicity and preferred language of care were assessed using univariable and multivariable generalized linear modeling.ResultsThe pandemic cohort included fewer patients of Hispanic ethnicity and fewer Spanish-speakers. After controlling for visit type, comparison of Spanish-speaking and English-speaking patients revealed that Spanish-speaking families had significantly lower scores for FES items that evaluated healthcare provider explaining (IRR 0.74, 95% CI: 0.61–0.90), listening (IRR 0.76, 95% CI: 0.63–0.92), and time spent with the family (IRR 0.73, 95% CI: 0.60–0.89). There were no differences in FES responses based on insurance status or degree of medical complexity.ConclusionsTelehealth services were less commonly used among Hispanic and Spanish-speaking patients. Language may differentially affect family satisfaction with healthcare and telehealth solutions. Strategies to mitigate these inequities are needed and may include strengthening interpreter services and providing language-concordant care.Level of evidenceLevel IV. |
