Age and Medicare Insurance are Barriers to Telemedicine Access—A Quality Improvement Project

Vashisht Madabhushi, Christopher J. McLouth, Robert King, Avinash Bhakta, Sandra Beck, Jitesh A. Patel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Telehealth use has had widespread expansion and adoption over the past two years. This study aims to evaluate access to telehealth essentials (TE) using a novel metric. Methods: This single institute study surveyed outpatient surgical patients to determine their access to TE. Generalized linear mixed models were used to determine the relationship of demographic and county-level variables on access to four TE. Results: 138 patients were surveyed. Sixty-six (47.8%) were from Appalachian Kentucky. In the survey cohort, 122 (88.4%) had smart phones, 109 (80.7%) had devices with video messaging capabilities, 106 (80.9%) had cellular reception, and 112 (82.4%) had access to WiFi. Increasing age and Medicare insurance were the most consistent predictors of lack of access to TE. Conclusion: Rural Appalachian Kentucky has access to TE. Telehealth has the potential to decrease the healthcare inequity in rural populations, but incompletely address this inequity for the aging population.

Original languageEnglish
Pages (from-to)1643-1649
Number of pages7
JournalAmerican Surgeon
Issue number5
StatePublished - May 2023

Bibliographical note

Publisher Copyright:
© The Author(s) 2022.


  • appalachia
  • elderly
  • medicare
  • rural
  • telehealth

ASJC Scopus subject areas

  • Surgery


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