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Sustained use and determinants of telehealth in metropolitan cancer care: A multi-centre retrospective study beyond the COVID-19 pandemic
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DOI：10.1177/1357633x261456154.png)
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Abstract
En 中文
<jats:sec>
<jats:title>Introduction</jats:title>
<jats:p>Telehealth use expanded rapidly in oncology during the COVID-19 pandemic, but determinants for ongoing use in metropolitan cancer care after the pandemic remain unclear.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A multi-centre retrospective cohort study of 271,889 oncology outpatient consultations (face-to-face, telephone, video) from 1 January 2019 to 30 June 2024 across four cancer centres in Sydney, Australia was conducted. Consultations were divided into pre-COVID, during-COVID restrictions and post-COVID restriction time periods. Multivariable generalised estimating equations modelled the odds of telehealth use in the during and post-restriction periods, testing interactions between time periods and key covariates.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>
Across 271,889 consultations with 21,125 patients the proportion of telehealth consultations was negligible pre-pandemic (0.4%), peaked during restrictions (24.7%) then reduced but was sustained post-restrictions (11.4%). Post-restrictions, telehealth use was more likely for follow-up consultations (vs new,
<jats:italic toggle="yes">p</jats:italic>
< .001), medical oncology consultations (vs radiation,
<jats:italic toggle="yes">p</jats:italic>
< .001), patients enrolled on a clinical trial (
<jats:italic toggle="yes">p</jats:italic>
< .001) and primary tumours including brain and genitourinary (vs breast,
<jats:italic toggle="yes">p</jats:italic>
< .001). Patients from the most socioeconomically disadvantaged quintiles (vs highest,
<jats:italic toggle="yes">p</jats:italic>
< .001), those who required an interpreter (
<jats:italic toggle="yes">p</jats:italic>
< .001), those receiving active treatment in the cancer centre (vs not on treatment,
<jats:italic toggle="yes">p</jats:italic>
< .001) and with primary tumours including head and neck or skin (vs breast,
<jats:italic toggle="yes">p</jats:italic>
< .001) were less likely to undergo telehealth consultations.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>There is modest but sustained use of telehealth in oncology post-pandemic restrictions particularly for follow-up consultations, with less utilisation in populations experiencing disadvantage. Strategic, equity-focused policies are needed to ensure that telehealth use enhances, rather than exacerbates, disparities in access to cancer care.</jats:p>
</jats:sec>
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