Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
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DOI：
10.1016/j.ahj.2023.06.011
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发表时间：
2023-09
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
2019冠状病毒病疫情加速了远程医疗在心脏病诊所的应用。在大流行病初期，远程医疗的使用存在社会人口差异。目前尚不清楚这些差异是否持续存在，以及它们是否与获得护理的患者人群的变化有关。我们检查了2019年3月至2020年2月（COVID前）和2020年3月至2021年2月（COVID）期间北方加州一家学术机构和附属社区诊所的所有成人心脏病学就诊。我们比较了这两个时期患者的社会人口学特征。我们使用逻辑回归来评估COVID期间患者/就诊特征与就诊方式（面对面与远程医疗以及基于视频与电话的远程医疗）的关联。新冠肺炎前及新冠肺炎前的到访人次分别为54，948人次及58，940人次。在新冠疫情期间，远程医疗的使用从<1%增加到70.7%（49.7%视频，21.0%电话）。两个时期的患者社会人口统计学特征相似。在调整后的分析中，来自某些社会人口学群体的患者不太可能通过远程医疗进行就诊，当通过远程医疗进行就诊时，通过视频与电话进行就诊的可能性更小。在使用基于视频的远程医疗方面，年龄≥80岁的患者观察到的差异最大（相对于年龄<60岁，OR 0.24，95% CI 0.21，0.28），黑人患者（vs非西班牙裔白色，OR 0.64，95% CI 0.56，0.74），英语水平有限的患者（与英语熟练者相比，OR 0.52，95% CI 0.46-0.59），以及接受医疗补助的人（与私人保险者相比，OR 0.47，95% CI 0.41-0.54）。在大流行的第一年，接受心血管护理的患者的社会人口特征保持稳定，但护理方式在各组之间存在差异。在使用远程医疗与现场护理方面存在差异，最明显的是使用视频远程医疗与使用电话远程医疗。未来的研究应该检查不同患者群体数字医疗保健访问的障碍和结果。
The COVID-19 pandemic accelerated adoption of telemedicine in cardiology clinics. Early in the pandemic, there were sociodemographic disparities in telemedicine use. It is unknown if these disparities persisted and whether they were associated with changes in the population of patients accessing care. We examined all adult cardiology visits at an academic and an affiliated community practice in Northern California from March 2019 to February 2020 (pre-COVID) and March 2020 to February 2021 (COVID). We compared patient sociodemographic characteristics between these periods. We used logistic regression to assess the association of patient/visit characteristics with visit modality (in-person vs telemedicine and video- vs phone-based telemedicine) during the COVID period. There were 54,948 pre-COVID and 58,940 COVID visits. Telemedicine use increased from <1% to 70.7% of visits (49.7% video, 21.0% phone) during the COVID period. Patient sociodemographic characteristics were similar during both periods. In adjusted analyses, visits for patients from some sociodemographic groups were less likely to be delivered by telemedicine, and when delivered by telemedicine, were less likely to be delivered by video versus phone. The observed disparities in the use of video-based telemedicine were greatest for patients aged ≥80 years (vs age <60, OR 0.24, 95% CI 0.21, 0.28), Black patients (vs non-Hispanic White, OR 0.64, 95% CI 0.56, 0.74), patients with limited English proficiency (vs English proficient, OR 0.52, 95% CI 0.46-0.59), and those on Medicaid (vs privately insured, OR 0.47, 95% CI 0.41-0.54). During the first year of the pandemic, the sociodemographic characteristics of patients receiving cardiovascular care remained stable, but the modality of care diverged across groups. There were differences in the use of telemedicine vs in-person care and most notably in the use of video- vs phone-based telemedicine. Future studies should examine barriers and outcomes in digital healthcare access across diverse patient groups.
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影响因子：
20.1
作者：
Powell-Wiley TM;Baumer Y;Baah FO;Baez AS;Farmer N;Mahlobo CT;Pita MA;Potharaju KA;Tamura K;Wallen GR
通讯作者：
Wallen GR
DOI：
10.15766/mep_2374-8265.10888
发表时间：
2020-03-13
影响因子：
--
作者：
Neff, Joshua;Holmes, Seth M;Nelson, Nicholas
通讯作者：
Nelson, Nicholas
影响因子：
9.7
作者：
Lau, Jen;Knudsen, Janine;Chokshi, Dave A.
通讯作者：
Chokshi, Dave A.
DOI：
10.1093/ehjdh/ztab039
发表时间：
2021-06
期刊：
European heart journal. Digital health
影响因子：
--
作者：
Brown KJ;Mathenge N;Crousillat D;Pagliaro J;Grady C;Katz N;Singh JP;Bhatt AB
通讯作者：
Bhatt AB
DOI：
10.1016/j.ssmqr.2022.100054
发表时间：
2022-12
期刊：
SSM. Qualitative research in health
影响因子：
--
作者：
Payán DD;Frehn JL;Garcia L;Tierney AA;Rodriguez HP
通讯作者：
Rodriguez HP