Background The surge of telemedicine use during the early stages of the COVID-19 pandemic has been well documented. However, scarce evidence considers the use of telemedicine in the subsequent period. Objective This study aims to evaluate use patterns of video-based telemedicine visits for ambulatory care and urgent care provision over the course of recurring pandemic waves in 1 large health system in New York City (NYC) and what this means for health care delivery. Methods Retrospective electronic health record (EHR) data of patients from January 1, 2020, to February 28, 2022, were used to longitudinally track and analyze telemedicine and in-person visit volumes across ambulatory care specialties and urgent care, as well as compare them to a prepandemic baseline (June-November 2019). Diagnosis codes to differentiate suspected COVID-19 visits from non–COVID-19 visits, as well as evaluating COVID-19–based telemedicine use over time, were compared to the total number of COVID-19–positive cases in the same geographic region (city level). The time series data were segmented based on change-point analysis, and variances in visit trends were compared between the segments. Results The emergence of COVID-19 prompted an early increase in the number of telemedicine visits across the urgent care and ambulatory care settings. This use continued throughout the pandemic at a much higher level than the prepandemic baseline for both COVID-19 and non–COVID-19 suspected visits, despite the fluctuation in COVID-19 cases throughout the pandemic and the resumption of in-person clinical services. The use of telemedicine-based urgent care services for COVID-19 suspected visits showed more variance in response to each pandemic wave, but telemedicine visits for ambulatory care have remained relatively steady after the initial crisis period. During the Omicron wave, the use of all visit types, including in-person activities, decreased. Patients between 25 and 34 years of age were the largest users of telemedicine-based urgent care. Patient satisfaction with telemedicine-based urgent care remained high despite the rapid scaling of services to meet increased demand. Conclusions The trend of the increased use of telemedicine as a means of health care delivery relative to the pre–COVID-19 baseline has been maintained throughout the later pandemic periods despite fluctuating COVID-19 cases and the resumption of in-person care delivery. Overall satisfaction with telemedicine-based care is also high. The trends in telemedicine use suggest that telemedicine-based health care delivery has become a mainstream and sustained supplement to in-person-based ambulatory care, particularly for younger patients, for both urgent and nonurgent care needs. These findings have implications for the health care delivery system, including practice leaders, insurers, and policymakers. Further investigation is needed to evaluate telemedicine adoption by key demographics, identify ongoing barriers to adoption, and explore the impacts of sustained use of telemedicine on health care outcomes and experience.
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Effects of the COVID-19 crisis on survey fieldwork: Experience and lessons from two major supplements to the U.S. Panel Study of Income Dynamics
Two major supplements to the Panel Study of Income Dynamics (PSID) were in the field during the COVID-19 outbreak in the United States: the 2019 waves of the PSID Child Development Supplement (CDS-19) and the PSID Transition into Adulthood Supplement (TAS-19). Both CDS-19 and TAS-19 abruptly terminated all face-to-face fieldwork and, for TAS-19, shifted interviewers from working in a centralized call center to working from their homes. Overall, COVID-19 had a net negative effect on response rates in CDS-19 and terminated all home visits that represented an important study component. For TAS-19, the overall effect of Covid-19 was uncertain, but negative. The costs were high of adapting to COVID-19 and providing paid time-off benefits to staff affected by the pandemic. Longitudinal surveys, such as CDS, TAS, and PSID, that span the pandemic will provide valuable information on its life course and intergenerational consequences, making ongoing data collection of vital importance.
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- Award ID(s):
- 2042875
- NSF-PAR ID:
- 10335574
- Date Published:
- Journal Name:
- Survey research methods
- Volume:
- 14
- Issue:
- 2
- ISSN:
- 1864-3361
- Page Range / eLocation ID:
- 241-245
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Wright College, an urban open-access community college, independently accredited within a larger community college system, is a federally recognized Hispanic-Serving Institution (HSI) with the largest community college enrollment of Hispanic students in its state. In 2018, Wright College received an inaugural National Science Foundation-Hispanic Serving Institution (NSF:HSI) research project grant “Building Capacity: Building Bridges into Engineering and Computer Science”. The project's overall goals are to increase underrepresented students pursuing an associate degree (AES) in engineering and computer science and streamline two transitions: high school to community college and 2-year to 4-year institutions. Through the grant, Wright College created a holistic and programmatic framework that examines and correlates engineering students' self-efficacy (the belief that students will succeed as engineers) and a sense of belonging with student success. The project focuses on Near-STEM ready students (students who need up to four semesters of math remediation before moving into Calculus 1). The project assesses qualitative and quantitative outcomes through surveys and case study interviews supplemented with retention, persistence, transfer, associate and bachelor's degree completion rates, and time for degree completion. The key research approach is to correlate student success data with self-efficacy and belonging measures. Outcomes and Impacts Three years into the project, Wright College Engineering and Computer Science Program was able to: • Develop and implement the Contextualized Summer Bridge with a total of 132 Near-STEM participants. One hundred twenty-seven (127) completed; 100% who completed the Bridge eliminated up to two years of math remediation, and 54% were directly placed in Calculus 1. All successful participants were placed in different engineering pathways, and 11 students completed Associate in Engineering Science (AES) and transferred after two years from the Bridge. • Increase enrollment by 940% (25 to 235 students) • Retain 93% of first-year students (Fall to fall retention). Seventy-five percent (75%) transferred after two years from initial enrollment. • Develop a holistic and programmatic approach for transfer model, thus increasing partnerships with 4-year transfer institutions resulting in the expansion of guaranteed/dual admissions programs with scholarships, paid research experience, dual advising, and students transferring as juniors. • Increase diversity at Wright College by bridging the academic gap for Near-STEM ready students. • Increase self-efficacy and belonging among all Program participants. • Increase institutionalized collaborations responsible for Wright College's new designation as the Center of Excellence for Engineering and Computer Science. • Increase enrollment, retention, and transfer of Hispanic students instrumental for Wright College Seal of Excelencia recognition. Lessons Learned The framework established during the first year of the grant overwhelmingly increased belonging and self-efficacy correlated with robust outcomes. However, the COVID-19 pandemic provided new challenges and opportunities in the second and third years of the grant. While adaptations were made to compensate for the negative impact of the pandemic, the face-to-face interactions were critical to support students’ entry into pathways and persistence within the Program.more » « less
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Abstract Background Belonging is a fundamental human motivation associated with a wide range of positive psychological, educational, social, and job outcomes. Frequent and predominantly conflict‐free interactions within a stable, relational framework of caring are required to facilitate belonging.
Purpose The goal of this study was to understand if and how emergency remote teaching (ERT) used during the COVID‐19 pandemic changed the ways in which instructional support and interactions were linked to belonging among engineering students.
Methodology/Approach This study used survey data from a cross‐sectional dataset at a single large institution comprised of sophomore to senior‐level students (
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Implications Rather than returning to pre‐pandemic traditional learning, a hybrid model that offers a more level playing field for marginalized students to find belonging in the classroom is recommended. In developing such models, faculty must take special care to avoid having a potentially negative impact on student belonging.
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.18148/srm/2020.v14i2.7752
