Characteristics of telehealth users in NYC for COVID-related care during the coronavirus pandemic

Abstract Objective To explore whether racial/ethnic differences in telehealth use existed during the peak pandemic period among NYC patients seeking care for COVID-19 related symptoms. Materials and Methods This study used data from a large health system in NYC – the epicenter of the US crisis – to describe characteristics of patients seeking COVID-related care via telehealth, ER, or office encounters during the peak pandemic period. Using multinomial logistic regression, we estimated the magnitude of the relationship between patient characteristics and the odds of having a first encounter via telehealth versus ER or office visit, and then used regression parameter estimates to predict patients’ probabilities of using different encounter types given their characteristics. Results Demographic factors, including race/ethnicity and age, were significantly predictive of telehealth use. As compared to Whites, Blacks had higher adjusted odds of using both the ER versus telehealth (OR: 4.3, 95% CI: 4.0-4.6) and office visits versus telehealth (OR: 1.4, 95% CI: 1.3-1.5). For Hispanics versus Whites, the analogous ORs were 2.5 (95% CI: 2.3-2.7) and 1.2 (95% CI: 1.1-1.3). Compared to any age groups, patients 65+ had significantly higher odds of using either ER or office visits versus telehealth. Conclusions The response to COVID-19 has involved an unprecedented expansion in telehealth. While older Americans and minority populations among others are known to be disadvantaged by the digital divide, few studies have examined disparities in telehealth specifically, and none during COVID-19. Additional research into sociodemographic heterogeneity in telehealth use is needed to prevent potentially further exacerbating health disparities overall.

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RACIAL DISPARITIES IN ACCESS TO AND COST OF HEALTHCARE AMONG OLDER ADULTS WITH COGNITIVE LIMITATION: 2002 TO 2016

Innovation in Aging ◽

10.1093/geroni/igz038.2085 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S564-S564

Author(s):

Elham Mahmoudi

Keyword(s):

Older Adults ◽

Prescription Drugs ◽

Linear Models ◽

Medical Expenditure Panel Survey ◽

Ethnic Disparities ◽

Office Visit ◽

Medical Expenditure ◽

Office Visits ◽

Vulnerable Subpopulations ◽

Racial Ethnic

Abstract Using 2002-2016 Medical Expenditure Panel Survey, we examined racial/ethnic disparities in office-visits and prescription-drugs among individuals with cognitive limitation (CL). Medicare beneficiaries (65+) with CL (N=9,369) were included. We used generalized linear models. Prevalence of CL increased overtime among all racial/ethnic groups. Our findings indicate that 96% of Whites vs. 93% of Blacks had at least one office visit (diff=0.03; 95% CI:0.01-0.04). Whites had 2 (95% CI: 1.0-0.4) and 4 (95% CI: 2.5-6.0) more office visits compared with Hispanics and Asians; and used 4 (95% CI: 1-6.9), 5 (95% CI:1.0-9.3) and 6 (95% CI: 1.0-11.5) more prescriptions than their Blacks, Hispanics, and Asians, respectively. Whites had higher annual expenditures for office-visits compared with Asians ($889; 95% CI:409-1,368) and higher expenditures for prescriptions compared with Blacks ($484; 95% CI:$151-$816) and Asians ($546; 95% CI:$28-$1064), respectively. Disparities in care among older adults with CL may put vulnerable subpopulations at a higher risk.

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Geosocial Factors Associated With Adherence to Statin Medications

Annals of Pharmacotherapy ◽

10.1177/1060028020934879 ◽

2020 ◽

Vol 54 (12) ◽

pp. 1194-1202 ◽

Cited By ~ 2

Author(s):

Steven R. Erickson ◽

Mercedes Bravo ◽

Joshua Tootoo

Keyword(s):

Age Groups ◽

Patient Characteristics ◽

Racial Isolation ◽

Geographic Accessibility ◽

Public Health Initiative ◽

Pharmacy Claims ◽

The Social ◽

Proportion Of Days Covered ◽

Statin Adherence ◽

The Relationship

Background: Individual patient characteristics, social determinants, and geographic access may be associated with patients engaging in appropriate health behaviors. Objective: To assess the relationship between statin adherence, geographic accessibility to pharmacies, and neighborhood sociodemographic characteristics in Michigan. Methods: The proportion of days covered (PDC) was calculated from pharmacy claims of a large insurer of adults who had prescriptions for statins between July 2009 and June 2010. A PDC ≥0.80 was defined as adherent. The predictor of interest was a ZIP code tabulation area (ZCTA)-level measure of geographic accessibility to pharmacies, measured using a method that integrates availability and access into a single index. We fit unadjusted models as well as adjusted models controlling for age, sex, and ZCTA-level measures of socioeconomic status (SES), racial isolation (RI) of non-Hispanic blacks, and urbanicity. Results: More than 174 000 patients’ claims data were analyzed. In adjusted models, pharmacy access was not associated with adherence (0.99; 95% CI: 0.96, 1.03). Greater RI (0.87; 95% CI: 0.85, 0.88) and urban status (0.93; 95% CI: 0.89, 0.96) were associated with lower odds of adherence. Individuals in ZCTAs with higher SES had higher odds of adherence, as were men and older age groups. Conclusion and Relevance: Adherence to statin prescriptions was lower for patients living in areas characterized as being racially segregated or lower income. Initiating interventions to enhance adherence, informed by understanding the social and systematic barriers patients face when refilling medication, is an important public health initiative that pharmacists practicing in these areas may undertake.

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Patient-satisfaction in an outpatient vein surgery office: A comparison of English- and Spanish-speaking patients

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517754172 ◽

2018 ◽

Vol 33 (10) ◽

pp. 672-677

Author(s):

Benjamin Vincent ◽

Vijaya Thakur ◽

Anjani Thakur

Keyword(s):

Patient Satisfaction ◽

Office Visit ◽

Office Visits ◽

Improve Patient Satisfaction ◽

Spanish Speaking ◽

The Us ◽

Before And After ◽

English Speaking ◽

Demand For Health ◽

Improve Patient

Background In spite of an increasing Latino population and accompanying rise in demand for health care, not much is known about patient-satisfaction in Spanish-speaking patients and how to improve patient-satisfaction when using interpreters. We sought to compare patient-satisfaction with vein surgery office visits between English-speaking and Spanish-speaking patients. Methods Directly before and after the office visit, 126 patients completed a socio-demographic survey, a five-point ordinal rating survey of physician and interpreter satisfaction with the encounter. Measures were satisfaction with the provider’s friendliness, respectfulness, concern, ability to make the patient comfortable, and time spent for the exam. Results When the provider was fluent in the language that the patient spoke, patients ( M = 4.954, SD = 0.21) were significantly more satisfied with their visit at VVHC than patients who required an interpreter ( M = 4.762, SD = 0.71), z = 2.230, p = 0.012. Spanish speaking patients were more likely to be satisfied with the visit when they felt their interpreter was friendly ( n = 58, p = 0.049). There was no difference found with regard to the provider being thoughtful and comforting. Conclusion Spanish-speaking patients are less satisfied with the care provided in a vein surgery office. Patients who communicated through an interpreter were less satisfied with the patient–provider relationship. In light of the growing diversity of the US population and the fact that patient-satisfaction is increasingly tied to reimbursement, additional research might identify potential areas of improvement for the surgeon, interpreter, and patient perspectives.

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Biological Characteristics and Medical Treatment of Breast Cancer in Young Women—A Featured Population: Results from the NORA Study

International Journal of Breast Cancer ◽

10.4061/2011/534256 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

P. Pronzato ◽

G. Mustacchi ◽

A. De Matteis ◽

F. Di Costanzo ◽

E. Rulli ◽

...

Keyword(s):

Young Women ◽

Univariate Analysis ◽

Age Groups ◽

Patient Characteristics ◽

Biological Characteristics ◽

Younger Women ◽

Hormone Receptor Positive ◽

Positive Nodal Status ◽

The Relationship

Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA studyPatients and Methods. From 2000–2002, patients () were enrolled at 77 Italian hospitals. Women aged years () were stratified into age groups (, 36–40, 41–45, and 46–50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed.Results. Younger women more frequently had tumors with ER/PgR-negative(; ), HER2 amplification (; ), and high () Ki67 labelling index (; ). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (, , and versus , , resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (, ).Conclusion. This cohort study suggests that ageper sèis an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.

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Social networks and labor market inequality between ethnicities and races

Network Science ◽

10.1017/nws.2013.20 ◽

2013 ◽

Vol 1 (3) ◽

pp. 321-352 ◽

Cited By ~ 2

Author(s):

OTT TOOMET ◽

MARCO VAN DER LEIJ ◽

MEREDITH ROLFE

Keyword(s):

Social Networks ◽

Economic Performance ◽

Regional Variation ◽

Wage Differential ◽

Strong Relationship ◽

Labor Market Inequality ◽

The Us ◽

The One ◽

The Relationship ◽

Racial Ethnic

AbstractThis paper analyzes the relationship between unexplained racial/ethnic wage differentials on the one hand and social network segregation, as measured by inbreeding homophily, on the other. Our analysis is based on both the US and Estonian surveys, supplemented with the Estonian telephone communication data. In the case of Estonia we consider the regional variation in economic performance of the Russian minority, and in the US case we consider the regional variation in black--white differentials. Our analysis finds a strong relationship between the size of the wage differential and network segregation: Regions with more segregated social networks exhibit larger unexplained wage gaps.

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Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008

Public Health Nutrition ◽

10.1017/s136898001700043x ◽

2017 ◽

Vol 20 (9) ◽

pp. 1584-1592 ◽

Cited By ~ 18

Author(s):

Denise M Deming ◽

Kathleen C Reidy ◽

Mary Kay Fox ◽

Ronette R Briefel ◽

Emma Jacquier ◽

...

Keyword(s):

School Children ◽

Age Groups ◽

National Sample ◽

Eating Patterns ◽

Infants And Toddlers ◽

Cross Sectional ◽

The Us ◽

Daily Energy ◽

Sectional Analysis ◽

Racial Ethnic

AbstractObjectiveTo explore eating patterns and snacking among US infants, toddlers and pre-school children.DesignThe Feeding Infants and Toddlers Study (FITS) 2008 was a cross-sectional national survey of children aged 6–47 months, weighted to reflect US age and racial/ethnic distributions. Dietary data were collected using one multiple-pass 24h recall. Eating occasions were categorized as meals, snacks or other (comprised of all feedings of breast milk and/or infant formula). The percentage of children consuming meals and snacks and their contribution to total energy, the number of snacks consumed per day, energy and nutrients coming from snacks and the most commonly consumed snacks were evaluated by age.SettingA national sample of US infants, toddlers and pre-school children.SubjectsA total of 2891 children in five age groups: 6–8 months (n 249), 9–11 months (n 256), 12–23 months (n 925), 24–35 months (n 736) and 36–47 months (n 725).ResultsSnacks were already consumed by 37 % of infants beginning at 6 months; by 12 months of age, nearly 95 % were consuming at least one snack per day. Snacks provided 25 % of daily energy from the age of 12 months. Approximately 40 % of toddlers and pre-school children consumed fruit and cow’s milk during snacks; about 25 % consumed 100 % fruit juice. Cookies were introduced early; by 24 months, 57 % consumed cookies or candy in a given day.ConclusionsSnacking is common, contributing significantly to daily energy and nutrient needs of toddlers and pre-school children. There is room for improvement, however, with many popular snacking choices contributing to excess sugar.

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Analysis of individual patient data to describe the incubation period distribution of Shiga-toxin producingEscherichia coli

Epidemiology and Infection ◽

10.1017/s0950268819000451 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 1

Author(s):

A. Awofisayo-Okuyelu ◽

I. Hall ◽

E. Arnold ◽

L. Byrne ◽

N. McCarthy

Keyword(s):

Incubation Period ◽

Shiga Toxin ◽

Individual Patient Data ◽

Age Groups ◽

Patient Characteristics ◽

Patient Data ◽

Bloody Diarrhoea ◽

Period Distribution ◽

Public Health Officials ◽

The Relationship

AbstractShiga-toxin producingEscherichia coli(STEC) is a pathogen that can cause bloody diarrhoea and severe complications. Cases occur sporadically but outbreaks are also common. Understanding the incubation period distribution and factors influencing it will help in the investigation of exposures and consequent disease control. We extracted individual patient data for STEC cases associated with outbreaks with a known source of exposure in England and Wales. The incubation period was derived and cases were described according to patient and outbreak characteristics. We tested for heterogeneity in reported incubation period between outbreaks and described the pattern of heterogeneity. We employed a multi-level regression model to examine the relationship between patient characteristics such as age, gender and reported symptoms; and outbreak characteristics such as mode of transmission with the incubation period. A total of 205 cases from 41 outbreaks were included in the study, of which 64 cases (31%) were from a single outbreak. The median incubation period was 4 days. Cases reporting bloody diarrhoea reported shorter incubation periods compared with cases without bloody diarrhoea, and likewise, cases aged between 40 and 59 years reported shorter incubation period compared with other age groups. It is recommended that public health officials consider the characteristics of cases involved in an outbreak in order to inform the outbreak investigation and the period of exposure to be investigated.

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Racial and regional differences in incidence of oropharyngeal cancer in the United States during 2001 to 2017.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6041 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6041-6041

Author(s):

Fangjian Guo ◽

Mihyun Chang ◽

Abbey Berenson

Keyword(s):

United States ◽

Confidence Interval ◽

Regional Differences ◽

Age Groups ◽

The United States ◽

Cancer Statistics ◽

Standard Population ◽

The Us ◽

Underlying Causes ◽

Racial Ethnic

6041 Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has been reported to be increasing among both middle-aged and elderly adults in the United States. This study was to assess racial and regional differences in the incidence of OPSCC among adults in the US. Methods: We included 271,037 adult patients ≥ 20 years old diagnosed with potentially HPV-related OPSCC from the US Cancer Statistics 2001–2017 database which essentially covered the entire US population. Incidence of OPSCC was age- adjusted to the US standard population. Annual percentage change (APC) in the incidence was assessed across races/ethnicities and regions of residence. Results: Among these adults with potentially HPV-related OPSCC from 2001-2017, 5.3% were Hispanics, 83.0% were non-Hispanic Whites, and 9.2% were non-Hispanic Blacks, and 79.1% were male. Incidence of OPSCC increased from 3.9 per 100,000 in 2001 to 4.0 per 100,000 in 2017 (APC 0.43, 95% confidence interval (CI) 0.01, 0.85) in Hispanics, increased from 5.3 per 100,000 in 2001 to 8.6 per 100,000 in 2017 (APC 2.97, 95% confidence interval (CI) 2.71, 3.24) in non-Hispanic Whites, and decreased from 6.3 per 100,000 in 2001 to 5.1 per 100,000 in 2017 (APC -1.27, 95% confidence interval (CI) -1.56, -0.99) in non-Hispanic Blacks. The incidence increased from 5.8 per 100,000 in 2001 to 7.8 per 100,000 in 2017 (APC 1.94, 95% confidence interval (CI) 1.67, 2.21) in the South, increased from 5.0 per 100,000 in 2001 to 7.1 per 100,000 in 2017 (APC 2.13, 95% confidence interval (CI) 1.92, 2.34) in the Northeast, increased from 4.9 per 100,000 in 2001 to 6.3 per 100,000 in 2017 (APC 1.85, 95% confidence interval (CI) 1.53, 2.17) in the West, and increased from 4.9 per 100,000 in 2001 to 7.7 per 100,000 in 2017 (APC 2.79, 95% confidence interval (CI) -2.52, 3.07) in the Midwest. The incidence decreased from 0.9 per 100,000 in 2001 to 0.8 per 100,000 in 2017 (APC -0.81, 95% confidence interval (CI) -1.41, -0.20) among adults 20-44 years old, increased from 9.0 per 100,000 in 2001 to 12.7 per 100,000 in 2017 (APC 2.01, 95% confidence interval (CI) 1.66, 2.36) among adults 45-64 years old, and increased from 10.9 per 100,000 in 2001 to 16.7 per 100,000 in 2017 (APC 2.96, 95% confidence interval (CI) 2.75, 3.16) among adults 65+ years old. Conclusions: OPSCC incidence increased across racial/ethnic groups, regions, and age groups from 2001 to 2017, except that the incidence decreased among non-Hispanic Blacks and young people. Underlying causes for the decreasing trend in the incidence of OPSCC among certain groups need further investigation.

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Dual Pandemics of COVID-19 and Systemic Racism: The Roles of Perceptions of Inequities, Civic Values, and Conservatism in Mask-Wearing Behavior

10.31234/osf.io/tf7qw ◽

2021 ◽

Author(s):

Christopher Wegemer ◽

Luise von Keyserlingk

Keyword(s):

Political Orientation ◽

Political Polarization ◽

Future Research ◽

Structural Racism ◽

Systemic Racism ◽

Civic Values ◽

The Us ◽

Political Conservatism ◽

The Relationship ◽

Racial Ethnic

Amid unprecedented political polarization, the US continues to grapple with the simultaneous crises of COVID-19 and structural racism. We examine potential predictors of COVID-19 mask-wearing at the intersection of these crises, with particular attention to the behavior of conservatives and young people, who have resisted compliance with efforts to contain the spread of COVID-19. Specifically, we investigate perceptions of racial/ethnic inequities in the healthcare system and civic values as predictors of COVID-19 mask-wearing frequency and potential moderators of the relationship between political orientation and COVID-19 mask-wearing frequency. Diverse college students at a university in southern California participated in our longitudinal survey, which was initiated prior to the COVID-19 pandemic (N = 431). We found that perceptions of inequities and civic values predicted mask-wearing, whereas political conservatism was negatively related to mask-wearing. Further, conservative participants were more likely to wear masks if they reported greater perceptions of inequities. Our results provide a foundation for future research that may inform targeted public health interventions aimed at encouraging responsible COVID-19 behavior and fostering dialogue on structural equities in a contentious political environment.

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The health of older Western Australians: the role of age, gender, geographic location, psychological distress, perceived health, tobacco and alcohol

Advances in Dual Diagnosis ◽

10.1108/add-12-2020-0026 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Celia Wilkinson ◽

Kim Clarke ◽

Ros Sambell ◽

Julie Dare ◽

Stephen Jason Bright

Keyword(s):

At Risk ◽

Multinomial Logistic Regression ◽

Oldest Old ◽

Age Groups ◽

Geographic Location ◽

Well Being ◽

Drinking Behaviour ◽

Psychological Well Being ◽

Content Type ◽

The Relationship

Purpose Rates of drinking- and alcohol-related harms among older adults are increasing in most developed nations. The purpose of this paper was to explore the relationship among at-risk alcohol use, smoking, gender, geographical location, self-reported health and psychological well-being among Western Australians aged 65 years and older. Design/methodology/approach A secondary analysis was conducted of a cross-sectional survey that collected data from 7,804 West Australians aged 65 years and older between 2013 and 2015. Participants were categorised according to the following age groups: young-old (aged 65–74 years), older-old (aged 75–84 years) and oldest-old (aged 85+ years). Findings Results from a multinomial logistic regression analysis indicated that at-risk drinking decreased with increasing age. Current smokers, males and those males and females who perceived their health to be “excellent” were more likely to report at-risk drinking, as were the oldest-old males who lived in remote communities. Psychological well-being was not a predictor of at-risk drinking Originality/value This paper examines drinking behaviour among a diverse population of older Western Australians. The way in which the age groups were segmented is unique, as most studies of older Australian drinking patterns aggregate the older adult population. Some of the authors’ findings support existing literature, whereas the remainder provides unique data about the relationship among at-risk drinking, geographic location and psychological well-being.

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