Improving telehealth accessibility assessment with a demographics-weighted two-step virtual catchment area (DW-2SVCA) method

Abstract The use of telehealth has significantly increased in recent years, providing patients with remote access to healthcare services. To measure accessibility of telehealth services, two-step virtual catchment area (2SVCA) methods have been developed as a broadband-aware extension of the traditional two-step floating catchment area (2SFCA) framework. Although telehealth utilization varies across demographic groups, existing 2SVCA approaches do not account for such variation and typically treat population demand as uniform. To address the knowledge gap, this study proposes the demographic-weighted 2SVCA (DW-2SVCA), which enhances the 2SVCA framework by adjusting telehealth demand through a weight matrix based on demographic characteristics, including age, gender, race, and ethnicity. In a case study of primary healthcare in Mecklenburg County, North Carolina, we applied the proposed method to measure telehealth accessibility and compared it with the existing 2SVCA approach. While the overall statistical and spatial patterns were similar, DW-2SVCA exhibited greater variance in accessibility values. To further evaluate whether the proposed method more effectively captures demographic variations in telehealth utilization, we classified the study area into four groups based on demographic profiles by using hierarchical clustering and conducted statistical tests. The results revealed that the DW-2SVCA method indicates more pronounced and statistically significant differences, with higher accessibility in regions characterized by white and middle-aged populations and lower accessibility in more racially/ethnically diverse areas. This study offers a more comprehensive tool for evaluating telehealth accessibility, highlighting the importance of incorporating demographic variations in telehealth utilization.