Association among age, sex, and geographical region with health care utilization through the Ontario telemedicine network

Abstract

The Ontario Telemedicine Network (OTN) facilitates virtual health care services across all of Ontario. Founded in 2006, OTN has allowed patients to access specialized care that was once only accessible in urban settings.1 The services that the services that OTN facilitates has impacted the health and quality of life of hundreds of thousands of residents in the province. It has been suggested that telemedicine decreases the patient’s need to travel long distances to receive appropriate health care.2,3 Traveling to medical appointments is time-consuming and poses many safety risks to those residing in Ontario, particularly for northern and rural residents.2,3 Further, it can create issues of inequity (e.g., vehicle ownership), social disruption, and anxiety in the populations who must travel to seek health care. A lack of public transportation is another reason why patients and providers may choose to use telemedicine over in-person services.4,5 The use of telemedicine services in the Ontario population is not well understood. Specifically, it is unknown how telemedicine service utilization varies between men and women, and among various age groups. It is also unknown how utilization rates within these age and sex groups differ by patient geography; and particularly in older adults, where there is growing familiarity and comfort with telemedicine technologies. To fill this knowledge gap, more research is needed to understand how telemedicine can be used to help older adults, especially those with chronic health conditions.6 Thus, my thesis sought to determine what telemedicine services are utilized through OTN. More specifically, administrative billing data from April 2008 to March 2015 were analyzed to determine what age and sex groups are using telemedicine services most frequently and to further investigate these population utilization rates in a rural and urban context. This study is the first to examine the associations among age, sex and utilization of OTN services. The results show which OTN therapies were most sought out by Ontario patients in different age and sex groups and how utilization rates vary by region and rurality. This study also examined whether telemedicine in Ontario is targeting particular demographics (i.e., if a clinical service area is being utilized by a particular age, sex, or regional group). Through dissemination and knowledge translation, this study hopes to inform rural, northern policy and decision-makers on the OTN utilization patterns of men and women in different age groups, and potentially providing justification on how funding resources should be allocated to improve the specialized health care services that are most needed in the community.