INTRODUCTION During the COVID-19 pandemic, telehealth services represented a critical tool in maintaining continuity and access to care for adults in the USA. However, despite improvements in access and utilization during the pandemic, disparities in telehealth utilization have persisted. It is unclear what role access and willingness to use telehealth play in telehealth disparities. METHODS We used data from the nationally representative COVID-19's Unequal Racial Burden (CURB) survey, an online survey conducted between December 2020 and February 2021, n = 5500. Multivariable Poisson regression was used to estimate the prevalence of perceived telehealth access and willingness to use telehealth services among adults with and without chronic conditions. RESULTS Overall, 60.1% of adults with and 38.7% of adults without chronic conditions reported having access to telehealth. After adjustment, adults with chronic conditions were more likely to report telehealth access (adjusted prevalence ratio [aPR] = 1.35, 95% confidence interval [CI] = 1.21-1.50). Most adults with and without chronic conditions reported being willing to use telehealth services (85.1% and 79.8%, respectively), and no significant differences in willingness were observed across chronic condition status (aPR = 1.03, 95% CI = 0.95-1.13). Perceived telehealth access appeared to be a predictor of telehealth willingness in both groups (chronic conditions: aPR = 1.22, 95% CI = 0.97-1.54; no chronic conditions: aPR = 1.37, 95% CI = 1.22-1.54). The prevalence of perceived barriers to telehealth was low, with the majority reporting no barriers (chronic conditions = 51.4%; no chronic conditions = 61.4%). DISCUSSION Perceived access to telehealth was associated with telehealth willingness. Investing in approaches that increase telehealth accessibility and awareness is needed to improve access to telehealth for adults with and without chronic conditions.

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在 COVID-19 大流行期间，针对患有或不患有慢性疾病的美国成年人的全国代表性多样化样本进行远程医疗获取、意愿和障碍。

简介 在 COVID-19 大流行期间，远程医疗服务是维持美国成年人连续性和获得护理的关键工具。然而，尽管大流行期间的访问和利用有所改善，但远程医疗利用方面的差异仍然存在。目前尚不清楚使用远程医疗的机会和意愿在远程医疗差异中发挥什么作用。方法 我们使用了具有全国代表性的 COVID-19 不平等种族负担 (CURB) 调查的数据，这是一项 2020 年 12 月至 2021 年 2 月期间进行的在线调查，n = 5500。使用多变量泊松回归来估计感知远程医疗访问的普遍性和接受远程医疗的意愿。在患有或不患有慢性病的成年人中使用远程医疗服务。结果 总体而言，60.1% 患有慢性病的成年人和 38.7% 没有慢性病的成年人表示能够获得远程医疗服务。调整后，患有慢性病的成年人更有可能报告远程医疗接入（调整后患病率 [aPR] = 1.35，95% 置信区间 [CI] = 1.21-1.50）。大多数患有和不患有慢性病的成年人都表示愿意使用远程医疗服务（分别为 85.1% 和 79.8%），并且在慢性病状态之间没有观察到意愿存在显着差异（aPR = 1.03，95% CI = 0.95-1.13）。感知远程医疗访问似乎是两组远程医疗意愿的预测因素（慢性病：aPR = 1.22，95% CI = 0.97-1.54；无慢性病：aPR = 1.37，95% CI = 1.22-1.54）。远程医疗感知障碍的发生率较低，大多数人表示没有障碍（慢性病 = 51.4%；无慢性病 = 61.4%）。讨论 对远程医疗的感知与远程医疗意愿相关。需要投资于提高远程医疗可及性和意识的方法，以改善患有或不患有慢性病的成年人获得远程医疗的机会。