Trends in Prenatal Telehealth Visits by Race and Ethnicity in U.S. Community Health Centers, 2019 to 2023.

Abstract

Telehealth increased substantially during the COVID-19 pandemic. There is evidence that telehealth can improve access to care. Little is known about the use of patients' telehealth prenatal care prevalence by race and ethnicity, especially in CHCs. To assess patient usage of telehealth prenatal visits by race and ethnicity between 2019 and 2023, we included EHR data from pregnant non-Hispanic, Latina, White and Black patients and measured the proportion of telehealth prenatal visits. Adjusted estimated marginal means were calculated and described using a generalized beta mixed effects model to account for clinic clustering. The proportion of prenatal telehealth visits increased rapidly for all groups until 2021, when they slowly began to decline and level off. In 2019, White Latinas had the lowest percent (11.3%, 95% CI = 11.0, 11.6) and non-Hispanic Black patients had the highest percent (13.7%, 95% CI = 13.2, 14.2). By 2023, non-Hispanic White patients had the highest percentage (25.0% 95% CI = 24.4, 25.6) and Black Latinas had the lowest percentage (18.2%, 95% CI = 17.1, 19.4). While all racial and ethnic groups exhibited similar trends in telehealth usage, the shifts in percentages highlight important disparities. This research lays the groundwork to evaluate prenatal outcomes related to virtual care and help clinics prioritize effective strategies in telehealth services for prenatal care.