Demographic Trends in Telehealth Access during COVID-19

Over the course of the last year, the COVID-19 pandemic has drastically changed the healthcare landscape. The virus’ ability to spread rapidly throughout the population has discouraged many Americans from receiving healthcare in crowded hospitals and clinics. Instead, they have opted for telehealth, an alternative introduced decades ago that has only recently seen its popularity peak due to COVID-19.

Statistics from multiple studies and the CDC show a significant increase in telehealth visits at the start of 2020. The CDC obtained and analyzed data from the four largest telehealth providers in the country. Telehealth visits increased by 50% during the first 13 weeks of 2020 from January to March, compared with the same period in 2019. Week 13 of 2020 saw an increase of 154% compared with the same week in 2019 [1]. The timing of this increase is significant, since people started to have a heightened alertness of this novel coronavirus around this time in March. Another study examined telehealth visits to providers at the UCSF Cancer Center during pre- and post-COVID-19 periods. The researchers defined the pre-COVID-19 period as the weeks from January 1st to March 13, 2020. The post-COVID-19 period was defined as the weeks from March 16 to May 31, 2020. During the pre-COVID-19 period, 23,988 ambulatory episodes and 2284 video visits were recorded. During the post-COVID-10 period, 20,567 ambulatory episodes and 12,946 video visits were recorded [2]. The decrease in in-person visits and the massive increase in video visits are indicative of patients’ acceptance of telehealth as a way to receive care.

Demographic data reveals that age plays a significant role in telehealth access. Adults aged 18-49 increased their use of telehealth from 2019 to 2020, while there was no increase for adults older than 49 years old [1]. Despite the pandemic, older adults statistically still prefer in-person medical visits, which can be explained partly by lack of knowledge and access to technology. Lonergan et al. observed that minorities, including African American, Hispanic, and Asian patients were quick to utilize and adapt to the benefits of telehealth; all three of these groups saw greater increases in telehealth visits compared to white patients [2]. Out of these minorities, Hispanics had the highest usage. Furthermore, telehealth usage increased by 493% for patients living in urban areas during the post-COVID-19 period, but only increased by 260% for patients living in rural areas [2].

Although some chose telehealth as an alternative to in-person visits, total visits at the start of the pandemic decreased by 9% among a national sample of 16.7 million individuals with commercial or Medicare insurance. Total visits, comprised of in-person visits and telehealth visits, declined in every state, revealing how COVID-19 led to deferred care across the country at the start of the pandemic [3]. Policy changes such as the CARES Act strived to provide a seamless transition for those who wanted care without endangering themselves and others. The CARES Act encouraged providers to serve more patients by providing higher payments, including telehealth in Medicaid benefits, and authorizing a wide variety of providers to utilize telehealth [1]. Although some physical interactions between provider and patients cannot be replaced by telehealth, patients have benefitted from telehealth’s safety and convenience during these unique times.


1. Koonin LM, Hoots B, Tsang CA, et al. Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic — United States, January–March 2020. MMWR Morb Mortal Wkly Rep 2020;69:1595–1599. DOI: 10.15585/mmwr.mm6943a3

2. Lonergan PE, Washington SL III, Branagan L, Gleason N, Pruthi RS, Carroll PR, Odisho AY. Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19: Cross-Sectional Analysis. J Med Internet Res 2020;22(7):e19322. DOI: 10.2196/19322

3. Patel SY, Mehrotra A, Huskamp HA, Uscher-Pines L, Ganguli I, Barnett ML. Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US. JAMA Intern Med. Published online November 16, 2020. DOI: 10.1001/jamainternmed.2020.5928