Objective: To assess the patient-related barriers to access of some virtual healthcare tools among cancer patients in the USA in a population-based cohort . Materials & methods: National Health Interview Survey datasets (2011-2018) were reviewed and adult participants (≥18 years old) with a history of cancer diagnosis and complete information about virtual healthcare utilization (defined by [a] filling a prescription on the internet in the past 12 months and/or [b] communicating with a healthcare provider through email in the past 12 months) were included . Information about video-conferenced phone calls and telephone calls are not available in the National Health Interview Survey datasets; and thus, they were not examined in this study . Multivariable logistic regression analysis was used to evaluate factors associated with the utilization of virtual care tools .
Results: A total of 25,121 participants were included in the current analysis; including 4499 participants (17.9 %) who utilized virtual care in the past 12 months and 20,622 participants (82.1 %) who did not utilize virtual care in the past 12 months . The following factors were associated with less utilization of virtual healthcare tools in multivariable logistic regression: older age (continuous odds ratio [OR] with increasing age : 0.987; 95% CI : 0.984-0.990), African-American race (OR for African American vs white race : 0.608; 95% CI : 0.517-0.715), unmarried status (OR for unmarried compared with married status : 0.689; 95% CI : 0.642-0.739), lower level of education (OR for education ≤high school vs> high school : 0.284; 95% CI : 0.259-0.311), weaker English proficiency (OR for no proficiency vs very good proficiency : 0.224; 95% CI : 0.091-0.552) and lower yearly earnings (OR for earnings <$ 45,000 vs earnings> $45,000 : 0.582; 95% CI : 0.523-0.647). Conclusion: Older patients, those with African-American race, lower education, lower earnings and weak English proficiency are less likely to access the above studied virtual healthcare tools . Further efforts are needed to tackle disparities in telemedicine access.