Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

The Effect of the COVID‐19 Pandemic on the Use of Telehealth in cancer care: a multi-centre study (#412)

Jiawang Cao 1 , Andrew O Parsonson 2 3 4 , Gui Xiong 5 6 , Mei Ling Yap 1 5 7 8
  1. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  2. Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, NSW, Australia
  3. Clinical Trials Unit, Macquarie University Hospital, Macquarie University, NSW, Australia
  4. Department of Medical Oncology, Nepean Cancer Care and Wellness Centre, Kingswood, NSW, Australia
  5. South Western Sydney Local Health District, Liverpool, NSW, Australia
  6. Ingham Institute, Liverpool, NSW, Australia
  7. Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute UNSW Sydney, Liverpool, NSW, Australia
  8. The George Institute for Global Health, UNSW Sydney, Barangaroo, NSW, Australia

Aim: The COVID-19 pandemic resulted in a rapid uptake of Telehealth use for outpatient consultations in cancer care. The aim of this study was to evaluate the factors associated with the use of telehealth in South Western Sydney Local Health District (SWSLHD) during and after the restrictions of the COVID-19 pandemic.

Methods: Data was obtained from the SWSLHD Radiation Oncology Virtual Clinical Quality Registry for patients who had a specialist appointment between January 2018 and June 2024 across four cancer centres. Descriptive statistics were used to describe patterns of telehealth use and regression analyses were used to assess factors associated with telehealth utilisation.

Results: There were 273082 outpatient consultations identified for 21125 unique patients. The use of telehealth (phone or video consultations) peaked during COVID19 restrictions in 2021 with 26% of all consultations being conducted over Telehealth, that reduced to 8% of all encounters in 2023 and 2024. For all consultations: 53% of patients were female, 42% were aged over 70, 65% were married, 8% required an interpreter and 28% had advanced stage disease. Factors associated with higher telehealth use included consultations with female patients (OR 1.11, 95% CI 1.08-1.13, p<0.001) and patients residing in non-metropolitan (OR 1.43, 1.39-1.48, p<0.001) or socio-economic advantaged areas (OR 1.39, 1.33-1.46, p<0.001). Factors associated with lower Telehealth use were consultations with patients who never married (OR 0.92, 0.89-0.95, p<0.001), required an interpreter (OR 0.54, 0.51-0.57, p<0.001) or were born overseas in a non-English-proficient country (OR 0.79, 0.77-0.81, p<0.001). 

Conclusion: There is reduced but sustained use of Telehealth in outpatient cancer care services beyond the COVID19 pandemic. Although Telehealth is a useful adjunct to in-person modes of care delivery, it remains comparatively underutilised in populations who experience disadvantage. Initiatives and policies to help reduce disparate use of Telehealth in cancer care are required.