Gender Bias in Remote Service Delivery – Evidence from Healthcare
The COVID-19 pandemic resulted in a massive shift to the remote delivery of services. In this paper, we examine if the gender of the service provider moderates this transition. Specifically, we utilize data on in-person and virtual primary healthcare to study if the gender of the physician affects the shift to virtual healthcare. We find that female physicians experienced a 5.7% larger reduction in the delivery of services via conventional methods during the pandemic. Although female providers delivered a greater extent of their services digitally (2.2%), they suffered a net decrease in the services they provided (3.4%). For female physicians, the likelihood of having a child in the household was correlated with the amount of virtual services provided. However, correlations between being a parent and digital delivery of service were absent for male physicians. Relative to their male colleagues, female healthcare providers with lower autonomy (such as nurse practitioners and physician assistants) did not use a significantly higher amount of telemedicine. Their digital service provision was also uncorrelated with being a parent. Finally, women’s presence in firms increased remote service delivery – physicians of both genders in majority-female clinics provided significantly more telemedicine. Overall, female physicians experienced a 2.36 percentage point lower reimbursement relative to male physicians during the initial period of the COVID-19 pandemic. These results underscore the gendered difference of the shift to remote services, implications for mothers, low autonomy workers, and institutions.
Does Telemedicine Transcend Disparities or Create a Digital Divide? Evidence from the COVID-19 Pandemic
We examine telemedicine utilization during the COVID-19 pandemic. Advocates have argued that telemedicine can overcome barriers in accessing healthcare and protect patients from contracting COVID-19. Rural and poor patients, for example, would not need to make expensive and time-consuming trips to healthcare facilitates when using telemedicine. Conversely, telemedicine adoption may depend on broadband access and technology skills, which could create a digital divide and exacerbate disparities. We study these questions using data on virtual and conventional care from a large commercial insurer. Telemedicine utilization soared during the pandemic. We further find that telemedicine utilization was concentrated in urban and affluent markets. We attribute this to two factors. First, telemedicine use was correlated with broadband penetration. Second, telemedicine adoption was much higher for patients with an established healthcare provider relationship (i.e., received care in the same health system in the previous year). We also find that telemedicine utilization was lower among older patients and comorbidities; cohorts with the greatest risk of severe illness and death from COVID-19. Without further intervention, telemedicine could exacerbate existing health care disparities.
Contact Person: Lucy Xiaolu Wang