Racial and ethnic differences in telemedicine use among community‐dwelling older adults with dementia

Background Routine ambulatory care is essential for older adults with Alzheimer's disease and related dementias (ADRD) to manage their health conditions. The federal government expanded telemedicine coverage to mitigate the impact of the COVID‐19 pandemic on ambulatory services, which may provide an opportunity to improve access to care. This study aims to examine differences in telemedicine use for ambulatory services by race, ethnicity, and community‐level socioeconomic status among community‐dwelling older adults with ADRD. Methods This retrospective cohort study used Medicare claims data between April 01, 2020 and December 31, 2021. We included community‐dwelling Medicare fee‐for‐service beneficiaries aged 65 years and older with ADRD. The outcome variable is individual's use (yes/no) of telemedicine evaluation and management (tele‐EM) visits in each quarter. The key independent variables are race, ethnicity, and community‐level socioeconomic status. Results The analytical sample size of the study was 2,068,937, including 9.9% Black, 82.7% White, and 7.4% Hispanic individuals. In general, we observed a decreasing trend of tele‐EM use, and the average rate of quarterly tele‐EM use was 23.0%. Tele‐EM utilization varied by individual race, ethnicity, and community‐level socioeconomic status. On average, White and Black individuals in deprived communities were 3.5 and 2.4 percentage‐points less likely to use tele‐EM compared with their counterparts in less‐deprived communities (p