{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:26:18Z","timestamp":1787646378964,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Electronic consultations (e-consults) provide a strategic solution to address challenges in health care systems related to cost management and access to care. This study aims to investigate the multilevel patient characteristics associated with higher frequency of receiving e-consults and increased likelihood of completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>University of Colorado\u2019s electronic medical record were analyzed to study factors influencing referral types (e-consult vs. standard) and their completion rates from April 2018 to September 2023. Multivariate probit regression assessed the impact of patient-level and community-level factors (urban\u2013rural classification, Social Vulnerability Index, and technology accessibility) on e-consult referrals and completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In 263,882 records, 92.5% were standard referrals, and 7.4% were e-consult referrals. Analysis showed that females were less likely than males (OR = 0.95, 95%CI[0.93, 0.96]), and Blacks were more likely than Whites (OR = 1.03, 95%CI[1.01,1.06]) to receive e-consult referrals. Medicaid patients had lower odds compared to those with Medicare only (OR = 1.04, 95%CI[1.00,1.07]), and rural residency was associated with lower odds (OR = 0.80, 95%CI[0.73,0.88]) of e-consult referral. Factors such as areas with higher population without internet subscription (OR = 1.03, 95%CI[1.01,1.04]) and higher social vulnerabilities (OR = 1.26, 95%CI[1.16,1.37]) increased e-consult odds. Black patients were less likely to have their referrals completed compared to Whites. Patients who resided in regions with limited computer and smartphone access, as well as higher social vulnerabilities, showed decreased odds of referral completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussions and Conclusion:<\/jats:title>\n                    <jats:p>This study highlights the need for partnering with a variety of health care organizations, especially those serving low-income and disadvantaged populations, to enhance health care access equity through the use of e-consults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2024.0243","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T09:28:23Z","timestamp":1722245303000},"page":"2682-2688","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring Patterns and Disparities in E-Consult Referrals: An Analysis of Patient and Community Factors in Colorado Health Care"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7793-7948","authenticated-orcid":false,"given":"Asal","family":"Pilehvari","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA."},{"name":"UVA Comprehensive Cancer Center, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"You","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA."},{"name":"UVA Comprehensive Cancer Center, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Grim","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado, USA."},{"name":"University of Colorado School of Public Health, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodger","family":"Kessler","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado, USA."},{"name":"University of Colorado School of Public Health, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Thomas","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado, USA."},{"name":"University of Colorado School of Public Health, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X18784416"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/21501327211005303"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3745-y"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05124"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13933"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2017.09.005"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmw024"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001472"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.24628"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2018.0005"},{"key":"e_1_3_6_12_2","unstructured":"AAMC. Project CORE: Coordinating Optimal Referral Experiences. Available from: https:\/\/www.aamc.org\/what-we-do\/mission-areas\/health-care\/project-core [Last accessed: March20 2024]."},{"key":"e_1_3_6_13_2","unstructured":"Agriculture USD of. Economics Research Services.:Urban-Rural Continuum Codes. 2020 Available from: https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes.aspx."},{"key":"e_1_3_6_14_2","unstructured":"Centers for Disease Control and Prevention\/Agency for Toxic Substances and Disease Registry\/Geospatial Research A and Services Program. CDC\/ATSDR Social Vulnerability Index. 2018"},{"key":"e_1_3_6_15_2","unstructured":"American Community Survey 5-year estimates. 2021 2017. Available from: https:\/\/www.census.gov\/data\/developers\/data-sets\/acs-5year.html."},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781118887486"},{"key":"e_1_3_6_17_2","unstructured":"StataCorp. 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