Telemedicine Use

Household Pulse Survey

census experimental data

To rapidly monitor recent changes in the use of telemedicine, the National Center for Health Statistics (NCHS) and the Health Resources and Services Administration’s Maternal and Child Health Bureauexternal icon (HRSA MCHB) partnered with the Census Bureau on an experimental data system called the Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the impact of the coronavirus pandemic in the U.S.

The data collection period for Phase 1 of the Household Pulse Survey occurred between April 23, 2020 and July 21, 2020. Phase 2 data collection occurred between August 19, 2020 and October 26, 2020.  Phase 3 data collection occurred between October 28, 2020 and March 29, 2021. Phase 3.1 data collection occurred between April 14, 2021 and July 5, 2021. Data collection for Phase 3.2 began on July 21, 2021 and will continue through October 11, 2021.

Beginning in Phase 3.1, NCHS and HRSA MCHB worked with the Census Bureau to add questions on telemedicine use among adults and in households with children. Prior to that, in June-August, 2020 NCHS added questions on telemedicine use to its experimental web-based survey platform, the Research and Development Survey (RANDS), to provide timely data on this mode of healthcare access during the COVID-19 pandemic. RANDS is currently in the field and will have 2021 estimates this summer. Please see more details under “Data Source” about important differences between telemedicine measurement between Household Pulse Survey and RANDS.

Estimates on this page are derived from the Household Pulse Survey and show the percentage of a) adults aged 18 and over who at any time in the last four weeks had an appointment with a health professional by video or phone and b) households with at least one child under 18 years of age who at any time in the last four weeks had an appointment with a health professional by video or by phone.

See the technical notes for more information on these measures.


Use the drop-down menus to show data for selected indicators or categories. Select the buttons at the bottom of the dashboard to view national and state estimates. The data table may be scrolled horizontally and vertically to view additional estimates.


Technical Notes

 

Survey Questions

At any time in the last 4 weeks, did you have an appointment with a doctor, nurse, or other health professional by video or by phone? Please only include appointments for yourself and not others in your household.

Among households with at least one child under 18 years of age:
At any time in the last 4 weeks, did any children in the household have an appointment with a doctor, nurse, or other health professional by video or by phone?

Notes:
Groups included under the indicator for one or more telemedicine visits for any children in the household may reflect characteristics of the household (income) or of the adult respondent (education, race/Hispanic ethnicity, health insurance coverage). The adult survey respondent may or may not be the parent or guardian of a child living in the same household. The characteristics of the adult respondent may or may not match the characteristics of the children in the household.

 

Data Source

The U.S. Census Bureau, in collaboration with five federal agencies, launched the Household Pulse Survey to produce data on the social and economic impacts of the COVID-19 pandemic on American households.  The Household Pulse Survey was designed to gauge the impact of the pandemic on employment status, consumer spending, food security, housing, education disruptions, and dimensions of physical and mental wellness.

The survey was designed to meet the goal of accurate and timely estimates. It was conducted by an internet questionnaire, with invitations to participate sent by email and text message. The sample frame is the Census Bureau Master Address File Data. Housing units linked to one or more email addresses or cell phone numbers were randomly selected to participate, and one respondent from each housing unit was selected to respond for him or herself. Estimates are weighted to adjust for nonresponse and to match Census Bureau estimates of the population by age, sex, race and ethnicity, and educational attainment. All estimates shown meet the NCHS Data Presentation Standards for Proportionspdf icon.

The adult weight was used to generate estimates of one or more telemedicine visits for adults, while the household weight was used to generate estimates of one or more telemedicine visits for children among households with at least one child in the household.

Telemedicine measurement in RANDS versus the Household Pulse Survey

The Household Pulse Survey’s question on adult telemedicine use is similar in structure to the question in RANDS except for the reference period.  The Household Pulse Survey asks about telemedicine use within a four-week window, while RANDS asks about use within a two-month window. In RANDS, the telemedicine question is only asked of adults who report having a usual source of care and is specific to that provider, whereas the Household Pulse Survey asks the questions of all adults (adult estimates) or households with at least one child resident (household with child estimates).  Although both RANDS and the Household Pulse Survey are primarily internet-based there are important differences in non-response bias and potential survey error between the two surveys.  Therefore, the telemedicine questions and estimates should be not be directly compared between RANDS and the Household Pulse Survey.

See the RANDS technical notes for more information on these measures.

Weighted Response Rate and Sample Size
Week Weighted Response Rate Sample Size (Adult) Sample Size (Households with Children)
April 14 – 26 6.6% 54,835 17,070
April 28-May 10 7.4% 62,895 20,047
May 12-24 6.8% 58,286 18,658
May 26-June 7 6.7% 56,436 17,632
June 9-21 6.4% 54,267 17,053
June 23-July 5 6.3% 52,838 16,639
July 21-Aug 2 6.1% 55,699 17,373
Aug 4-16 6.5% 59,362 18,655
Aug 18-30 6.5% 59,705 18,608

Limitations

The Household Pulse Survey is different from other surveys. NCHS, the Census Bureau, and other federal statistical agencies are considered the preeminent source of the nation’s most important benchmark surveys.  Many of these surveys have been in production for decades and provide valuable insight on health, social, and economic trends. However, the production of benchmark data requires a relatively long lead time, and personal interviews (face-to-face or telephone) require additional time.  While efforts are underway to introduce COVID-19 questions into these surveys, that process can take months, sometimes years, before data are made available.

The Household Pulse Survey is different:  It was designed to go into the field quickly, to be administered via the web, and to disseminate data in near real-time, providing data users with information they can use now to help ease the burden on American households and expedite post-pandemic recovery.  The Census Bureau is fielding the Household Pulse Survey as a demonstration project, with data released as part of its Experimental Statistical Products Series.

Confidence intervals included in the tables on this page only reflect the potential for sampling error.  Nonsampling errors can also occur and are more likely for surveys that are implemented quickly, achieve low response rates, and rely on online response.  Nonsampling errors for the Household Pulse Survey may include:

  • Measurement error: The respondent provides incorrect information, or an unclear survey question is misunderstood by the respondent. The Household Pulse Survey schedule offered only limited time for testing questions.
  • Coverage error: Individuals who otherwise would have been included in the survey frame were missed. The Household Pulse Survey only recruited households for which an email address or cell phone number could be identified.
  • Nonresponse error: Responses are not collected from all those in the sample or the respondent is unwilling to provide information. The response rate for the Household Pulse Survey was substantially lower than most federally sponsored surveys.
  • Processing error: Forms may be lost, data may be incorrectly keyed, coded, or recoded. The real-time dissemination of the Household Pulse Survey provided limited time to identify and fix processing errors.

For more information on nonresponse bias for the 2020 Household Pulse Survey, please visit https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020_HPS_NR_Bias_Report-final.pdfpdf iconexternal icon.

For more information on the Household Pulse Survey, please visit https://www.census.gov/householdpulsedataexternal icon.

Page last reviewed: September 8, 2021