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

Introduction: Telehealth has the potential to improve health care access and reduce disparities. We examined whether the density of medical cannabis (MC) patients, stratified by those who were seen by a telemedicine provider or not, is associated with a concentrated disadvantage within Pennsylvania in 2022. Methods: This zip code-level analysis assessed associations between the concentrated disadvantage index (CDI) and counts of telemedicine-approved and all other MC patients. Total MC patient counts were obtained from Pennsylvania's Department of Health, counts of telemedicine-approved MC patients were obtained from a telehealth provider (Leafwell), and CDI data were obtained from the 2022 American Community Survey. Multivariable negative binomial regression models with population offsets and robust standard errors were used, accounting for spatial autocorrelation through spatial lag adjustments. Results: The CDI was not associated with the number of telemedicine-approved MC patients (incidence rate ratios [IRR] = 0.962; p = 0.355) but was significantly negatively associated with all other MC patients (IRR = 0.904; p = <0.001). The number of in-office MC providers was significantly associated with the count of all other MC patients but not with telemedicine-approved patients. Spatial factors significantly influenced the distribution of both patient groups. Discussion: These findings suggest that telemedicine may play a crucial role in reducing access disparities for MC in socioeconomically disadvantaged areas. The lack of a significant association between CDI and telemedicine-approved MC patients indicates that telehealth services can overcome barriers such as provider scarcity and transportation issues. By facilitating remote consultations and approvals, telemedicine expands access for patients who might otherwise be unable to obtain MC.