ASPO Abstracts
Telehealth use among adolescent and young adult (AYA) cancer survivors during the COVID-19 pandemic
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Telehealth emerged during the COVID-19 pandemic as a substitute to in-person care. Telehealth has the potential to address access to care disparities, but little is known about telehealth use for populations such as rural adolescent and young adult cancer survivors (AYAs) who have unique healthcare needs. We report on demographic factors associated with telehealth use in Utah-based AYAs during the pandemic. Methods: Electronic health records for a large academic medical center and cancer registry records were used to identify AYAs diagnosed with cancer age 15-39 between 1986-2020. Participants had at ≥1 outpatient healthcare visit from 03/2020-07/2022 (N=5,898). Outcomes: 1) telehealth vs. in-person outpatient visits and 2) telehealth type (video vs. telephone). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of AYAs, 63.3% were female. Average age at follow-up start was 40.4(SD=10.9); 15.0% were Hispanic, and melanoma (18.5%) and thyroid (13.8%) cancers were most common. In total, 44.5% had ≥1 telehealth visit. White vs. non-White race (OR=1.26, CI:1.16-1.23), public vs. private insurance (OR=1.17, CI:1.12-1.23), female vs. male (OR=1.07, CI:1.03-1.20), and rural vs. urban (OR=1.4, CI:1.33-1.49) were associated with increased odds of telehealth visits. Earlier time from diagnosis (<1 yr vs. 15+ yrs: OR=0.88, CI:0.80-0.96) was associated with lower telehealth odds. For telehealth type, video visits (88.9%) were more common than telephone visits (11.0%). When demographic differences between telehealth types were examined, odds of telephone visits were lower with increasing age (OR=0.98, CI:0.98-0.99). Telephone visits were more common for AYAs who are male (OR=1.36, CI:1.19-1.55 vs. female), and publicly insured (OR=1.98, CI:1.72-2.29 vs. privately insured). Conclusion: During the COVID-19 pandemic, telehealth saw an increase in use overall, particularly among rural and publicly insured AYAs who traditionally have reported lower access to care. Research on telehealth's impact on AYA cancer survivors and possible trade-offs in access and quality of care from telehealth access are needed.
Keywords: Telehealth, AYA, COVID-19