Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency.
Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency.
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DOI：
10.1007/s11606-022-07887-6
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发表时间：
2023-02
影响因子：
5.7
通讯作者：
Reed, Mary E.
中科院分区：
文献类型：
--
作者：
Hsueh, Loretta;Huang, Jie;Millman, Andrea K.;Gopalan, Anjali;Parikh, Rahul K.;Teran, Silvia;Reed, Mary E.
在新冠肺炎大流行期间，远程医疗的急剧增加提高了解决远程医疗中患者-护理差距的重要性，特别是对于英语水平有限的患者。检查患者语言和患者提供者语言与远程医疗访问类型(视频访问与电话访问)的一致性。从2020年3月16日至2020年10月31日对患者安排的初级保健远程医疗预约的横断面自动化数据研究。北加州综合医疗保健服务系统。所有22,427名完成了初级保健远程医疗访问，计划由13,764名英语水平有限的患者通过患者门户进行访问。电子健康记录记录的患者语言(参考西班牙语)和患者-提供者语言与患者选择视频(而不是电话)访问的横断面关联，考虑了患者的社会人口统计、技术获取和技术熟悉因素。在所有患者预定的就诊中，34.5%(n=7747)是视频就诊。排在前三位的语言是西班牙语(42.4%)、广东话(16.9%)和普通话(10.3%)。调整社会人口学、技术准入和熟悉度因素，与说西班牙语的患者相比，说广东话(OR=1.34，95%CI：1.18-1.52)、普通话(OR=1.33，95%CI：1.16-1.52)或越南语(OR=1.27，95%CI：1.09-1.47)的患者使用视频访问的比例较高，而说旁遮普语的患者视频访问使用率较低(OR=0.75，95%CI：0.75，0.62-0.91)。语言一致性与较低的视频访问使用(OR=0.86，95%CI：0.80-0.93)以及说西班牙语、广东话和韩语与视频访问使用的适度关联有关。此外，对于所有语言组，以前使用视频访问的人比以前没有使用过视频访问的人更有可能重复使用视频访问(p<；0.05对于除印地语以外的所有语言，p=0.06)。在语言不同、英语水平有限的患者中，视频远程医疗的使用因具体语言而异。分解患者亚群数据对于识别那些最有可能受到数字鸿沟负面影响的人是必要的。网上版载有补充材料，可在10.1007/s11606-022-07887-6查阅。
Telemedicine’s dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. To examine the associations of patient language and patient-provider language concordance with telemedicine visit type (video versus telephone visit). Cross-sectional automated data study of patient-scheduled primary care telemedicine appointments from March 16, 2020, to October 31, 2020. Northern California integrated healthcare delivery system. All 22,427 completed primary care telemedicine visits scheduled by 13,764 patients with limited English proficiency via the patient portal. Cross-sectional association of electronic health record–documented patient language (Spanish as referent) and patient-provider language concordance with patients’ choice of a video (versus telephone) visit, accounting for patient sociodemographics, technology access, and technology familiarity factors. Of all patient-scheduled visits, 34.5% (n = 7747) were video visits. The top three patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). Adjusting for sociodemographic and technology access and familiarity factors and compared to patients speaking Spanish, video visit use was higher among patients speaking Cantonese (OR = 1.34, 95% CI: 1.18–1.52), Mandarin (OR = 1.33, 95% CI: 1.16–1.52), or Vietnamese (OR = 1.27, 95% CI: 1.09–1.47), but lower among patients speaking Punjabi (OR = 0.75, 95% CI: 0.75, 0.62–0.91). Language concordance was associated with lower video visit use (OR = 0.86, 95% CI: 0.80–0.93) and moderated associations of speaking Spanish, Cantonese, and Korean with video visit use. In addition, for all language groups, those with prior video visit use were more likely to re-use video visits compared to those with no prior use (p < .05 for all languages except Hindi with p = 0.06). Among linguistically diverse patients with limited English proficiency, video telemedicine use differed by specific language. Disaggregating patient subpopulation data is necessary for identifying those at greatest risk of being negatively impacted by the digital divide. The online version contains supplementary material available at 10.1007/s11606-022-07887-6.
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