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Telemedicine expands health care access for patients facing barriers to in-person care,1 but may also inadvertently widen existing care disparities2,3 for the 25 million people living in the US with limited English proficiency (LEP)4 because of overlapping low digital literacy and health literacy.5 Data on differential video vs telephone visit use by patients with LEP are needed to inform telemedicine equity strategies. In patients self-scheduling a primary care visit during the COVID-19 pandemic, we hypothesized that LEP would be associated with lower video use compared with telephone, especially among patients without prior video visit experience.
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Accepted for Publication: September 9, 2021.
Published: November 4, 2021. doi:10.1001/jamanetworkopen.2021.33129
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Hsueh L et al. JAMA Network Open.
Corresponding Author: Loretta Hsueh, PhD, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (Loretta.Hsueh@kp.org).
Author Contributions: Drs Hsueh and Huang had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Hsueh, Parikh, Reed.
Acquisition, analysis, or interpretation of data: Hsueh, Huang, Millman, Gopalan, Teran, Reed.
Drafting of the manuscript: Hsueh.
Critical revision of the manuscript for important intellectual content: Huang, Millman, Gopalan, Parikh, Teran, Reed.
Statistical analysis: Hsueh, Huang, Reed.
Obtained funding: Reed.
Administrative, technical, or material support: Millman, Parikh, Reed.
Conflict of Interest Disclosures: Ms Millman reported receiving grants from the Agency for Healthcare Research and Quality during the conduct of the study. Dr Reed reported receiving grants from the Agency for Healthcare Research and Quality and the National Institutes of Health during the conduct of the study. No other disclosures were reported.
Funding/Support: Dr Hsueh reported receiving support from the The Permanente Medical Group Delivery Science Fellowship program. This study was funded by the Agency for Healthcare Research and Quality (grant R01HS25189).
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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