Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study.
Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study.
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DOI：
10.2196/27982
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发表时间：
2021-07-23
影响因子：
7.4
通讯作者：
Tsugawa Y
中科院分区：
文献类型：
--
作者：
Miyawaki A;Tabuchi T;Ong MK;Tsugawa Y
在 COVID-19 大流行期间，许多国家远程医疗门诊的使用急剧增加。尽管按年龄和社会经济地位 (SES) 划分的获得远程医疗的差异已得到充分记录，但关于这些差异在 COVID-19 大流行期间如何变化的证据有限。此外，尽管远程医疗扩张潜力巨大，但在日本，患者获得远程医疗的公平性却鲜有报道。我们的目的是调查日本 COVID-19 大流行期间远程医疗使用中因年龄和社会经济地位差异而产生的变化。利用2020年8月25日至9月30日在日本进行的一项大型互联网调查的数据，我们研究了参与者年龄和SES（教育程度、居住城市性和收入水平）与他们在大流行期间以下两个时间段（2020年4月和2020年8月至9月）远程医疗使用的关联。在24,526名年龄在18岁至79岁之间的参与者中（50.8%） [n=12,446] 女性），报告使用远程医疗的人数比例从 2020 年 4 月的 2.0% (n=497) 增加到 2020 年 8 月至 9 月的 4.7% (n=1159)。在调整潜在的混杂因素后，2020 年 4 月，年轻的人比年长的人更有可能使用远程医疗。尽管这种模式在 2020 年 8 月至 9 月持续存在，我们还观察到 70 至 79 岁人群中远程医疗的使用大幅增加（调整后的比率，2020 年 4 月为 0.2%，2020 年 8 月至 9 月为 3.8%；多重比较后 P<.001）。我们发现，2020 年 8 月至 9 月 SES 在远程医疗使用方面存在差异，而 2020 年 4 月并不存在这种差异。2020 年 8 月至 9 月，拥有大学学历的人比高中或以下学历的人更有可能使用远程医疗（调整后比率，6.6% vs 3.5%；P<.001）。仅在 2020 年 8 月至 9 月期间，居住在城市地区的个人的远程医疗使用率高于居住在农村地区的个人（调整后的比率为 5.2% vs 3.8%；P<.001）。在这两个时期都没有观察到远程医疗使用因收入水平而存在差异。总体而言，在大流行期间，与老年人相比，年轻人更多地使用远程医疗，尽管 70 多岁的人也增加了远程医疗的使用。在 COVID-19 大流行期间，教育程度和居住城市程度在远程医疗使用方面的差异扩大了。
The use of telemedicine outpatient visits has increased dramatically during the COVID-19 pandemic in many countries. Although disparities in access to telemedicine by age and socioeconomic status (SES) have been well-documented, evidence is limited as to how these disparities changed during the COVID-19 pandemic. Moreover, the equity of patient access to telemedicine has been scarcely reported in Japan, despite the huge potential for telemedicine expansion. We aimed to investigate changes due to age and SES disparities in telemedicine use during the COVID-19 pandemic in Japan. Using data from a large internet survey conducted between August 25 and September 30, 2020, in Japan, we examined the associations of participant age and SES (educational attainment, urbanicity of residence, and income level) with their telemedicine use in the following two time periods during the pandemic: April 2020 and August-September 2020. Of the 24,526 participants aged 18 to 79 years (50.8% [n=12,446] women), the proportion of individuals who reported using telemedicine increased from 2.0% (n=497) in April 2020 to 4.7% (n=1159) in August-September 2020. After adjusting for potential confounders, younger individuals were more likely to use telemedicine than older individuals in April 2020. Although this pattern persisted in August-September 2020, we also observed a substantial increase in telemedicine use among individuals aged 70 to 79 years (adjusted rates, 0.2% in April 2020 vs 3.8% in August-September 2020; P<.001 after multiple comparisons). We found disparities in telemedicine use by SES in August-September 2020 that did not exist in April 2020. In August-September 2020, individuals with a university degree were more likely to use telemedicine than those with a high school diploma or less (adjusted rates, 6.6% vs 3.5%; P<.001). Individuals living in urban areas exhibited higher rates of telemedicine use than those living in rural areas only in August-September 2020 (adjusted rates, 5.2% vs 3.8%; P<.001). Disparities in telemedicine use by income level were not observed in either time period. In general, younger individuals increased their use of telemedicine compared to older individuals during the pandemic, although individuals in their 70s also increased their use of telemedicine. Disparities in telemedicine use by educational attainment and urbanicity of residence widened during the COVID-19 pandemic.
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影响因子：
2.9
作者：
Miyawaki A;Tabuchi T;Tomata Y;Tsugawa Y
通讯作者：
Tsugawa Y
影响因子：
7.8
作者：
Darrat, Ilaaf;Tam, Samantha;Williams, Amy M.
通讯作者：
Williams, Amy M.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
3.3
作者：
Hyler, SE;Gangure, DP;Batchelder, ST
通讯作者：
Batchelder, ST
影响因子：
11.1
作者：
Ioannidis JPA
通讯作者：
Ioannidis JPA