Missed appointments, or no-shows, disrupt healthcare delivery, exacerbating chronic disease management and leading to worse health outcomes. Telehealth has surged as a viable solution to reduce no-shows and improve healthcare accessibility, especially during the COVID-19 pandemic. However, telehealth disparities and its long-term efficacy across various medical specialties remain understudied. To address this, we performed a retrospective analysis of electronic health records from a heterogenous network of hospitals in Illinois, examining telehealth use and no-shows across among 444,752 adult patients with 1,973,098 outpatient encounters across nine specialties during the sustained pandemic phase (i.e., January 1, 2021 to July 1, 2022). Among them, 84,290 (4.27%) were no-shows, and telehealth constituted 202,933 (10.3%) of the total encounters. Telehealth use during the sustained phase varied significantly by specialty type. Overall, telehealth encounters were associated with reduced no-show odds compared to in-person encounters (OR, 0.28; 95% CI, 0.26–0.29). Black and Hispanic patients, as well as those with Medicaid, had higher no-show odds relative to their counterparts, even when using telehealth. Mental health specialty had the highest telehealth usage rate and the highest no-show odds (OR, 2.99; 95% CI, 2.84–3.14) relative to other specialties included in the study. Moreover, specialty type had differential effects on no-shows for telehealth. These results underscore the variability in telehealth use by specialty type and pervasive disparities telehealth use and no-shows. As we move beyond the pandemic, our findings can inform policymakers to tailor policies and incentives to reach different patient groups as well as specialties, with varying needs, to promote equitable telehealth utilization.

错过预约或缺席会扰乱医疗保健服务，加剧慢性病管理并导致更糟糕的健康结果。远程医疗已成为减少缺席和改善医疗保健可及性的可行解决方案，尤其是在 COVID-19 大流行期间。然而，远程医疗的差异及其跨不同医学专业的长期疗效仍未得到充分研究。为了解决这个问题，我们对来自伊利诺伊州异构医院网络的电子健康记录进行了回顾性分析，检查了 444,752 名成年患者的远程医疗使用情况和缺席情况，在持续的大流行阶段（即 1 月份），九个专科的门诊就诊次数为 1,973,098 次。 2021年1月1日至2022年7月1日）。其中，84,290 人次（4.27%）未出现，远程医疗占总就诊次数的 202,933 人次（10.3%）。持续阶段远程医疗的使用因专业类型而异。总体而言，与面对面就诊相比，远程医疗就诊与缺席几率降低相关（OR，0.28；95% CI，0.26-0.29）。即使使用远程医疗，黑人和西班牙裔患者以及享受医疗补助的患者相对于其他患者的缺席几率也更高。相对于研究中包含的其他专业，心理健康专业的远程医疗使用率最高，缺席几率最高（OR，2.99；95% CI，2.84-3.14）。此外，专业类型对远程医疗缺席的影响也不同。这些结果强调了不同专业类型远程医疗使用的差异性以及远程医疗使用和缺席的普遍差异。 当我们摆脱大流行的影响时，我们的研究结果可以帮助政策制定者制定政策和激励措施，以覆盖具有不同需求的不同患者群体和专业，以促进公平的远程医疗利用。