Impact of Social Determinants and Digital Literacy on Telehealth Acceptance for Pediatric Cardiology Care Delivery during the Early Phase of the COVID-19 Pandemic

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J Pediatrician. 2021 June 23:S0022-3476(21)00618-1. doi: 10.116/j.jpeds.2021.06.036. Online for print.


OBJECTIVE(S): To determine whether adoption of telecare by parents of children with heart disease is predicted by sociodemographic and/or digital literacy of parents; and to assess parental perceptions of the usefulness and reliability of TH.

STUDY DESIGN: We conducted a one-center study comparing TH acceptance with visit cancellation/rescheduling for pediatric cardiology visits during the early phase of the COVID19 pandemic. All parents/guardians who agreed to complete the survey received a validated survey assessing their DL. Consenting parents who accepted TH received an additional validated study assessing their perception of TH usefulness and reliability.

RESULTS: 849 patients were originally scheduled for in-person visits between March 30 and May 8, 2020. TH acceptance was highest in younger, publicly insured, Hispanic patients with primary diagnoses of arrhythmia/palpitations, chest pain, dysautonomia, dyslipidemia, and acquired heart disease. Among parents who completed surveys, DL was a determinant of TH acceptance. TH was established as a useful and reliable means of health care delivery.

CONCLUSION: While the potential for unequal selection of TH due to sociodemographic factors exists, we found that such factors were not a major determinant of pediatric cardiac care within a large, diverse, detached children’s hospital.

PMID:34174247 | DOI:10.1016/j.jpeds.2021.06.036

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