TOP 74 - Impact of Telemedicine in an Inner-City Ambulatory Pediatric Clinic: A Retrospective Healthcare Utilization and SDoH Analysis with Correlative Study of Physician Attitudes

Publication Number: 4779.TOP 74

Dixita I. Viswanath, NewYork-Presbyterian Morgan Stanley Children's Hospital, NEW YORK, NY, United States; Edith Bracho-Sanchez, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Shweta Antani, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Melissa Stockwell, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Background: Since the coronavirus pandemic, use of telehealth services has quickly become a crucial avenue to deliver healthcare. These virtual visits aim to mimic primary care settings while reducing physical social, and economic barriers to care to improve accessibility. While many hospital systems have expanded telehealth usage, replacing traditional face-to-face “sick” visits with telehealth for urgent care, even within a health care system, may raise concerns for health equity. A number of questions remain. First, do social drivers of health (SDoH) impact differences in utilization of in person vs. telehealth. Second, it is unknown how often telehealth vs. in person urgent care may result in a follow-up visit either in primary care or the emergency department (ED). Third, variability in physician comfort and practice level variations may impact the usability of telehealth in ambulatory pediatric settings.

Objective: We will 1) Evaluate the impact of SDoH and demographic factors on visit modality (telemedicine vs in-person); 2) Assess subsequent healthcare utilization in the 14 days following an urgent care visit by visit type (in person or telehealth); 3) Describe physician (attending and resident) attitudes towards telehealth urgent care to provide additional context to quantitative findings

Design/Methods: We extracted all in-person and telehealth urgent care visits over a 1-year period from October 2024 to September 2025 from an ambulatory care network affiliated with an academic medical center in the Washington Heights/Inwood neighborhoods of New York City. We will assess associations between SDoH (food, housing and transportation insecurity), race/ethnicity and language with visit type (in person vs. telehealth), using chi-squared analyses and logistic regression. We will calculate the number of urgent care (PCP, affiliated pediatric ED and/or hospitalization (if applicable) in the 14 days after index urgent care visit. We will then compare the mean number of visits between those who index visit was in person or via telehealth using t-tests and linear regression, as appropriate. We also distributed a survey to all pediatric residents and attendings (N=82), based on the validated Telehealth Usability Questionnaire. Participants were compensated $20. The overall response rate was 47% (n=39). Responses will be assessed using chi-squared and regression analyses, as appropriate including comparing residents to attendings. This study was approved by the Columbia University Institutional Review Board. All data have been received and data analyses will be completed by January 31, 2026.