Virtual Care and Medical Cannabis Access: A Geospatial Study of Telemedicine's Role in Reducing Socioeconomic Disparities

IntroductionTelemedicine has the potential to improve healthcare access and reduce disparities. We examined whether the incidence rate of medical cannabis patients (MC) was associated with concentrated disadvantage in Pennsylvania in 2022, accounting for a population of patients approved through telemedicine. MethodsThis zip code-level analysis examined associations between the Concentrated Disadvantage Index (CDI) and two outcomes: (1) the number of telemedicine-approved MC patients, as obtained from a specific telemedicine provider, and (2) the number of all other MC patients, calculated by subtracting the number of telemedicine-approved patients from the total number of MC patients at the zip code-level. Total counts of MC patients and in-office MC providers for Pennsylvania were sourced from the Pennsylvania Department of Health, while CDI data were derived from the 2022 American Community Survey. We used multivariate negative binomial regression models with population offsets and robust standard errors, adjusting for spatial autocorrelation through spatial lag adjustments. ResultsThe CDI was not associated with the incidence rate of telemedicine-approved MC patients (IRR = 0.962; p = 0.355), but it was significantly negatively associated with the incidence rate of all other MC patients (IRR = 0.904; p = 0.000). The density of in-office MC providers was significantly associated with the incidence rate of all other MC patients but not with telemedicine-approved patients. Spatial factors, including autocorrelation, significantly influenced the distribution of both groups of patients. DiscussionThese findings suggest that telemedicine plays a crucial role in improving access to MC for socioeconomically disadvantaged areas. The lack of a significant association between the CDI and telemedicine-approved MC patients highlights the ability of telemedicine to bypass barriers such as provider scarcity and transportation challenges. By facilitating remote consultations and approvals, telemedicine ensures access for patients who might otherwise face difficulties obtaining MC.