Telemedicine and visit completion among people with HIV during the coronavirus disease 2019 pandemic compared with prepandemic.
Telemedicine and visit completion among people with HIV during the coronavirus disease 2019 pandemic compared with prepandemic.
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DOI：
10.1097/qad.0000000000003119
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发表时间：
2022-03-01
期刊：
影响因子：
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通讯作者：
Chander G
中科院分区：
文献类型：
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作者：
El-Nahal WG;Shen NM;Keruly JC;Jones JL;Fojo AT;Lau B;Manabe YC;Moore RD;Gebo KA;Lesko CR;Chander G
在COVID-19疫情期间，远程医疗成为提供护理的主要模式。我们通过比较2019冠状病毒病大流行之前和期间从事护理的艾滋病毒感染者（PWH）的比例，描述了远程医疗对艾滋病毒感染者（PWH）获得护理的影响。我们对参加约翰霍普金斯HIV临床队列的患者进行了观察性分析，这是一个隶属于学术中心的城市HIV专科诊所的单中心队列患者。由于COVID-19大流行，诊所从面对面就诊转变为主要的远程医疗就诊。我们比较了两个时间段内接受护理的患者。大流行前期包括2019年9月1日至2020年3月15日期间计划进行≥1次访视的2，010人。大流行期间包括1，929人，计划在2020年3月16日至2020年9月30日期间进行≥1次访视。我们确定了每个阶段完成≥1次计划访视的患者比例。访视完成率从大流行前的88%显著增加到大流行期间的91%（p=0.008）。在大流行期间，20-39岁患者（82%至92%，p<0.001）、女性（86%至93%，p<0.001）、黑人患者（88%至91%，p=0.002）和可检测到病毒血症的患者（77%至85%，p=0.06）的访视完成率显著提高。在大流行期间，只有29%的人通过视频（而不是电话）完成了≥1次远程医疗就诊。在大流行期间，当通过远程医疗广泛提供护理时，大流行前参与度较低的群体的就诊完成率有所提高，但大多数仅限于电话就诊。
Telemedicine became the primary mode of delivering care during the COVID-19 pandemic. We describe the impact of telemedicine on access to care for people with HIV (PWH) by comparing the proportion of PWH engaged in care prior to and during the COVID-19 pandemic. We conducted an observational analysis of patients enrolled in the Johns Hopkins HIV Clinical Cohort, a single-center cohort of patients at an urban HIV subspecialty clinic affiliated with an academic center. Due to the COVID-19 pandemic, the clinic transitioned from in-person to mostly telemedicine visits. We compared patients receiving care in two time periods. The pre-pandemic period included 2,010 people with ≥1 visit scheduled between September 1st 2019 and March 15th 2020. The pandemic period included 1,929 people with ≥1 visit scheduled between March 16th 2020 and September 30th 2020. We determined the proportion of patients completing ≥1 of their scheduled visits during each period. Visit completion increased significantly from 88% pre-pandemic to 91% during the pandemic (p=0.008). Visit completion improved significantly for patients age 20–39 (82% to 92%, p<0.001), women (86% to 93%, p<0.001), Black patients (88% to 91%, p=0.002) and patients with detectable viremia (77% to 85%, p=0.06) during the pandemic. Only 29% of people that completed ≥1 telemedicine visit during the pandemic did so as a video (versus telephone) visit. During the pandemic when care was widely delivered via telemedicine, visit completion improved among groups with lower pre-pandemic engagement, but most were limited to telephone visits.