Rural, Regional, Racial Disparities in Telemedicine Use During the COVID-19 Pandemic Among US Adults: 2021 National Health Interview Survey (NHIS) [Letter]

Dear editor

We were very impressed with the article entitled “Rural, Regional, Racial Disparities in Telemedicine Use During the COVID-19 Pandemic Among US Adults: 2021 National Health Interview Survey (NHIS)”. The results of this research have advantages, namely: 1) Focus on comparative analysis of telemedicine usage patterns among adult populations living in rural and urban areas during the COVID-19 pandemic, 2) Evaluation of the probability of telemedicine adoption among adults living in rural and urban areas, 3) Emphasis on sociodemographic factors that influence access to healthcare, 4) Highlighting disparities in telemedicine use, particularly in rural areas, 5) Emphasizing the importance of healthcare strategies tailored to the unique characteristics of rural areas to achieve equitable access to healthcare.¹

However, we have also discovered several limitations that need to be corrected in the future, namely: 1) Use of cross-sectional data from the 2021 NHIS to investigate the relationship between telemedicine use and rural disparities. This may limit the ability to evaluate changes in telemedicine use over time, 2) The questionnaire for telemedicine use did not investigate the types and proportions associated with the modality, so the associations found may vary depending on the modality type, 3) Telemedicine use data was obtained through self-reported responses in the questionnaire, which may lead to the potential for underestimation due to responses that may be too low or too high, 4) Limitations in estimating the extent of telemedicine use in 2021, which may reflect the changing healthcare environment during the study period.

To obtain better results, we recommend that further research be carried out by 1) Using data that tracks telemedicine use over time will provide a better understanding of changes in telemedicine use patterns over time, 2) Investigating the types of telemedicine used and the proportion of use could provide greater insight into telemedicine usage preferences, 3) Validating telemedicine usage data with other sources, such as electronic medical records,² could help ensure the accuracy of results, 4) Conducting qualitative research to understand individuals’ perceptions and experiences related to telemedicine usage, as well as the barriers they face, could provide greater insight, 5) Investigating the impact of telemedicine-related policies, such as long-term payment policies, could provide an understanding of how such policies affect telemedicine access and usage.³

In conclusion, this study makes a significant contribution by highlighting the disparities in telemedicine use between rural and urban populations and highlights the importance of considering social and economic factors in efforts to achieve equitable access to healthcare.