Examining the Quality of Contraceptive Care Delivered Through Telehealth in a National Network of Reproductive Health Centers

Abstract

Objective:

With the onset of COVID-19 disruptions in the United States, Planned Parenthood rapidly expanded telehealth services to meet patient needs. This study examines patient and visit characteristics associated with telehealth use and compares the quality of contraceptive care delivered to telehealth and in-person patients.

Methods:

This cross-sectional study consisted of an electronic postvisit survey (N = 506, 2022) and a secondary analysis of electronic health record data from telehealth and in-person contraceptive patients (N = 59,691, 2020–2021) at five Planned Parenthood affiliates. We collected data on patient demographic characteristics, visit characteristics, and six dimensions of high-quality care from the Institute of Medicine’s framework. We conducted bivariate (for the relationships between patient/visit characteristics and telehealth use) and multivariable modified Poisson regression (for the relationships between modality and multiple quality of care measures), adjusting for patient and visit characteristics (where appropriate).

Results:

Patients who preferred Spanish or another language were less likely to have a telehealth visit compared with patients who preferred English (prevalence ratio [PR] = 0.45, 95% confidence interval [CI]: 0.29–0.67; PR = 0.26, 95% CI: 0.13–0.56, respectively). Patients who had a birth control-only visit were more likely to have a telehealth visit compared with patients who had a visit for birth control and other services (PR = 0.12, 95% CI: 0.05–0.25). A higher percentage of telehealth patients choose birth control pills than in-person patients (81% versus 54%; PR = 2.91, 95% CI: 1.81–4.70). We found no statistically significant differences in effectiveness, person-centeredness, safety, and equity. Telehealth patients were less likely to have a cycle time (time from appointment check-in to check-out) of ≥60 minutes (adjusted prevalence ration [aPR] = 0.07, 95% CI: 0.04–0.14) and a wait time of ≥10 minutes (aPR = 0.18, 95% CI: 0.09–0.34) than in-person patients.

Conclusion:

Our findings suggest that contraceptive care delivered through telehealth provides comparably high quality as in-person care. Telehealth care may offer benefits in the ease and speed of scheduling and attending appointments.