Utilisation of in-person and telehealth care among US adults with loneliness and social isolation

Clinical Snapshot

Key Findings

• P Value: Not specified in abstract

• Effect Size: Telehealth-only use increased by 2.6 (loneliness) and 5.4 (social isolation) percentage points

• Primary Outcome: Healthcare utilisation pattern (in-person only, telehealth only, combination)

• Nnt Or Sensitivity: For every 100 socially isolated adults, 5-6 additional individuals use telehealth-only care compared to non-isolated adults

• Confidence Interval: Loneliness: 1.1-4.2; Social isolation: 3.9-6.9 percentage points

Clinical Application

High feasibility given existing telehealth infrastructure, though requires systematic identification of at-risk populations Relevant to Australian practice given Medicare telehealth items introduced during COVID-19; RACGP guidelines support telehealth for appropriate conditions; PBS covers some telehealth consultations Adults experiencing loneliness or social isolation requiring healthcare services

Abstract

BACKGROUND: Telehealth has become a critical tool for improving access to care among populations facing physical barriers to in-person care. However, its potential role in delivering care to adults with social barriers remains underexplored. We examined whether adults with loneliness or social isolation are more likely to use telehealth care versus in-person care compared to adults without loneliness or social isolation. METHODS: This cross-sectional study analysed data for US adults in the 2021 Medical Expenditure Panel Survey. Loneliness and social isolation were measured using the UCLA Loneliness Scale and the Berkman-Syme Social Network Index. Three indicators of healthcare utilisation were used as outcomes: in-person care only, telehealth care only and a combination of both. RESULTS: Among adults experiencing loneliness and social isolation, the likelihood of using only in-person care was lower by 4.1 (95% CI -6.1 to -2.1) and 2.8 (95% CI -5 to -0.6) percentage points. In contrast, the likelihood of using only telehealth care was higher by 2.6 (1.1-4.2) and 5.4 (3.9-6.9). The likelihood of using both in-person and telehealth care was also higher by 2.3 (0.7-3.9) and 5.2 (3.7-6.7), but telehealth was used more frequently than in-person care. Furthermore, telehealth utilisation for mental health services was higher among adults experiencing loneliness or social isolation. CONCLUSION: Compared with adults who are not lonely or socially isolated, adults experiencing loneliness and social isolation are more likely to use telehealth and less likely to use in-person care. Telehealth may serve as a viable alternative for individuals facing social challenges in accessing in-person services.

References

1. 1.Park, S., Yu, J., & Jung, H. Y. (2026). Utilisation of in-person and telehealth care among US adults with loneliness and social isolation. Journal of Epidemiology and Community Health. https://doi.org/10.1136/jech-2025-223917