{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:41:00Z","timestamp":1791614460703,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG074946"],"award-info":[{"award-number":["R01AG074946"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD016389"],"award-info":[{"award-number":["R01MD016389"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Understanding the mix of video versus audio telehealth modality is critical to informing care for low\u2010income safety net clinic patients. Our study examined whether telehealth modality and continued use of telehealth varied by rurality and whether that changed over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Encounters from adults in the OCHIN national network of primary care safety net clinics were identified by encounter type (in\u2010person vs telehealth) and telehealth modality (video vs audio) from 4\/1\/2021 to 3\/31\/2023. Our main outcome was an interaction between patient rurality (defined using Rural Urban Commuting Area codes) and time. Linear probability models with clinic fixed effects were used to estimate predicted probabilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The predicted probability of a telehealth visit decreased from 37.9% to 24.7% among urban patients (<jats:italic>P<\/jats:italic> &lt;.001) and remained stable (29.5%\u201029.8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.82) among patients in small rural areas. By March 2023, telehealth use among patients in small rural areas was 5.1 percentage points higher than among urban patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). The predicted probability of an audio\u2010only visit ranged from 63.5% to 70.5% for patients across all levels of rurality, but no significant differences by rurality or time were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Safety net clinic patients were more likely to use audio\u2010only than video telehealth visits. Telehealth in urban and large rural areas decreased since the first year of the pandemic. By the end of the study, patients in small rural communities used significantly more telehealth than urban patients. Elimination of reimbursement for audio telehealth visits may exacerbate existing health care inequities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12887","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T04:54:29Z","timestamp":1727931269000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Video versus audio telehealth in safety net clinic patients: Changes by rurality and time"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0080-3220","authenticated-orcid":false,"given":"Annie E.","family":"Larson","sequence":"first","affiliation":[{"name":"Research Department OCHIN Inc.  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt C.","family":"Stange","sequence":"additional","affiliation":[{"name":"Center for Community Health Integration Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Heintzman","sequence":"additional","affiliation":[{"name":"Research Department OCHIN Inc.  Portland Oregon USA"},{"name":"Department of Family Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-8666","authenticated-orcid":false,"given":"Whitney E.","family":"Zahnd","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3293-5113","authenticated-orcid":false,"given":"Melinda M.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Oregon Rural Practice\u2010based Research Network, OHSU\u2010PSU School of Public Health, Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Marie","family":"Harvey","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences Oregon State University  Corvallis Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Chartbook on Rural Healthcare: National Healthcare Quality and Disparities Report","author":"Barton B","year":"2021"},{"key":"e_1_2_8_3_1","unstructured":"JonesC ParkerT AhearnM MishraA VariyamJ.Health Status and Health Care Access of Farm and Rural Populations. 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