Telemedicine Utilization, Availability of Physicians, Distance, and Urbanity: An Exploratory Study

Background

While demands for health services may not be reduced easily, it is possible to increase the availability of health services by utilizing new medical technology. One plausible solution is the utilization of telemedicine. Telemedicine may be defined as the provision of medical services that involves the exchange of medical information from one site to another via electronic communications for purposes of improving patients' health status (American Telemedicine Association 2012). Using telemedicine, a physician located in virtually anywhere can consult patients in underserved areas, prescribe treatment and even perform remotely directed minor surgeries (Bashshur & Shannon 2009; Courtney 2008; Paul 2004).

More specifically, telemedicine enables diagnosis and consultation by health providers to patients who reside in remote areas (Morrison et al. 2010; Pronovost et al. 2009). The term telehealth is sometimes used to indicate that telemedicine can be provided to patients at home or in medical facilities. In the former case, patients do not need to travel outside of home to receive services. This is desirable for older patients and for those who are physically disabled (Magnusson & Hanson 2005). Alternatively, patients can go to local clinics or medical centers to receive consultation from physicians in a telemedicine session, with the aid of nurses or medical assistants in the local medical facility (Kalternina et al. 2011). This study focuses on this latter case.

Intuitively, availability of physicians (McCarthy 1995), urbanity of a locality (Higgs 1999), and distance to an urban medical facility (Hassol et al. 1997) are decisive factors regarding the level of telemedicine utilization as an alternative form of medical consultation or treatment. For example, patients who reside in an underserved area, such as a rural town, need to travel for a long distance to an urban medical center to receive medical services. To avoid these travels, patients in underserved areas may be more likely to seek telemedicine in lieu of traditional, face-to-face health services. Yet, few studies in the literature examined how the supply of physicians, distance to an urban medical facility and the level of urbanity of a locality are associated with the utilization of telemedicine services with statistical precision. Figure 1 displays a model that may be developed systematically to account for the variations in the utilization of telemedicine.