Differential Trends in Telehealth Adoptions Among Urban and Rural Hospitals in the United States, 2008-2017

Anna Baucom, Dr. Peiyin Hung, and Dr. Kevin Bennett, Department of Health Services Policy and Management, University of South Carolina, Columbia SC 29208

In the wake of the COVID-19 pandemic, telehealth has become a promising measure to improve access to quality care. Understanding geographic disparities in telehealth adoptions is essential to guide future efforts for telehealth accessibility, especially in rural America where healthcare supply is limited. This study examined spatial distributions of telehealth and remote patient monitoring availability and the differential trends of telehealth adoptions over time across urban and rural hospitals. Nationwide longitudinal data from 2008-2017 American Hospital Association Annual Surveys on 5183 unique hospitals were linked to 2013 Urban Influence Codes to categorize hospital locations, yielding 1,698 and 1,744 urban, 491 and 470 rural micropolitan, and 653 and 589 rural noncore hospitals in 2008 and 2017, respectively. To identify differential effects of hospital location on telehealth adoptions over time, we employed generalized logistic regression models controlling for hospital characteristics and state indicators, adjusting for state-level clustering. Urban hospitals had a substantial increase in telehealth adoption from 44.3% in 2008 to 84.1% in 2017, whereas a less marked increase was seen for rural micropolitan hospitals from 48.7% to 82.8%, and the least increase existed across rural noncore hospitals from 47.4% to 67.2%. Despite the increasing trend of telehealth adoptions in rural hospitals, they are not evenly distributed, as small rural hospitals and freestanding hospitals have lagged in adoption. Similar but less prevalent trends were found in adopting remote patient monitoring systems across all hospitals. These findings signal the success of federal financial incentives for telehealth adoption in rural hospitals. However, unevenly distributed telehealth adoptions in rural America and slowly adopting telehealth/remote patient monitoring system among rural hospitals in recent years question the sustainability of the interventions. Amidst the pandemic, it is essential to ensure access to telehealth services and continuity of care for all patients, especially those with recent hospitalizations. 

Additional Abstract Information

Presenter: Anna Baucom

Institution: University of South Carolina - Columbia

Type: Poster

Subject: Nursing & Public Health

Status: Approved

Time and Location

Session: Poster 9
Date/Time: Wed 12:00pm-1:00pm
Session Number: 6054