Technological access barriers, telehealth use and health care visits in the early pandemic period

• Approximately 27.9 percent of respondents had ever used telehealth services; of these respondents, 75.6 percent had not used telehealth prior to March 2020. • Telehealth users were significantly more likely to have seen a health care provider in the past year for reproductive health or for an illness/specific health need. • Among all telehealth users, 55 percent reported that telehealth quality was about the same as traditional health services, while 39 percent of respondents reported the quality of telehealth to be somewhat or much worse. • Being over 65, male, or residing in a rural area were associated with reduced likelihood of ever using telehealth services. • Respondents over 65 and those with lower education attainment were more likely to experience technological barriers to telehealth; however, technological barriers did not predict lower rates of telehealth use. This study sought to characterize the role of technological barriers in limiting access to telehealth services. The study used data obtained from the 2020 Nebraska Annual Social Indicators Survey (NASIS). A total of 2,213 out of 8,000 respondents returned a completed survey. Multivariate models were developed to estimate the relationship between demographic characteristics, technological barriers and overall telehealth utilization. An additional model was used to estimate the relationship between telehealth use and health care visits in the past year, controlling for the available demographic characteristics. Ordinal logistic regression was used. Approximately 27.9 percent of respondents had ever used telehealth services. Individuals who had used telehealth services were significantly more likely to have seen a health care provider for reproductive health or for a specific health need in the past year. Approximately 7.2 percent of survey respondents reported access to reliable internet as a barrier to telehealth use, 9 percent reported cost of internet services as a barrier and 7.1 percent reported access to electronic devices as a barrier. Respondents over 65 and those with lower education attainment were more likely to experience barriers to accessing technology. Holding technological access constant, telehealth use was significantly lower among males, individuals over 65 and rural residents. Factors other than cost and access to technology may be driving lower rates of telehealth use among these populations. The findings can help policymakers and health systems strategize approaches to increase access to telehealth among underserved populations. Limitations in technology access may limit the usefulness of telehealth in connecting underserved patients to care. This study sought to understand the role of technological barriers in limiting access to telehealth services. Using data obtained from the 2020 Nebraska Annual Social Indicators Survey (NASIS), this study summarizes telehealth use among a random sample of individuals in rural and urban Nebraska. The study then assesses whether lower access to technology is associated with reduced use of telehealth services. Approximately 7.2 percent of survey respondents reported access to reliable internet as a barrier to telehealth use, 9 percent reported cost of internet services as a barrier and 7.1 percent reported access to electronic devices as a barrier. Holding technological access constant, telehealth use was lower among males, individuals over 65 and rural residents. Factors other than access to technology may be driving lower rates of telehealth use among these populations.