Quality of prenatal and postpartum telehealth visits during COVID-19 and preferences for future care.
Quality of prenatal and postpartum telehealth visits during COVID-19 and preferences for future care.
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DOI：
10.1016/j.xagr.2022.100139
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发表时间：
2023-02
期刊：
影响因子：
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通讯作者：
Diamond-Smith N
中科院分区：
文献类型：
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作者：
Marshall C;Gutierrez S;Hecht H;Logan R;Kerns J;Diamond-Smith N
在COVID-19大流行开始时，针对妊娠相关护理的远程医疗实践迅速实施。在大流行病之后，与怀孕有关的护理的远程保健可能会继续。为了使卫生系统和临床医生通过远程保健提供以人为本的妊娠相关护理，了解患者的远程保健经历及其对使用远程保健的偏好至关重要。本研究旨在描述COVID-19期间产前和产后远程医疗访问的感知质量，并检查大流行期间远程医疗质量与未来远程医疗偏好之间的关联。我们使用的数据来自18至45岁的美国女性在COVID-19期间寻求生殖健康护理的在线样本。于2020年7月及2021年1月收集了两个横断面的调查数据。这项分析包括那些在大流行期间寻求产前（n=1496）或产后（n=482）护理的人。在那些有产前或产后远程医疗访问，我们使用多变量logistic回归来检查感知远程医疗质量和开放性的措施之间的关联，未来的远程医疗访问，调整社会人口特征。共有57.5%的产前和52.9%的产后受访者有远程保健预约。受访者同意大多数关于其远程医疗预约质量的陈述，≥80%的受访者表示他们方便，简单，安全，并提供了良好的信息。排名较低的质量项目与访问感觉个人和病人的感觉照顾。共有35.2%的产前（n=816）和43.3%的产后（n=231）的受访者表示开放的远程保健访问在未来。报告远程保健质量较高的产前和产后受访者在未来接受远程保健的几率增加（产前：调整后的比值比，1.2; 95%置信区间，1.2-1.3;产后：调整后的比值比，1.2; 95%置信区间，1.1-1.3）。具有更好远程保健体验的产前和产后受访者更有可能对未来的远程保健表示开放，尽管大多数人更喜欢未来的面对面访问。随着与怀孕有关的远程保健的继续，重要的是提供符合患者偏好的预约选择，特别是在获得护理方面面临障碍的人群，并探索个性化护理和支持积极的患者-提供者关系的方法。
At the start of the COVID-19 pandemic, telehealth practices for pregnancy-related care were rapidly implemented. Telehealth for pregnancy-related care is likely to continue after the pandemic. In order for health systems and clinicians to provide person-centered pregnancy-related care via telehealth, it is critical to understand patients’ telehealth experiences and their preferences regarding the use of telehealth moving forward. This study aimed to describe perceived quality of prenatal and postpartum telehealth visits during COVID-19 and to examine the association between telehealth quality during the pandemic and future telehealth preferences. We used data from of an online sample of US women aged 18 to 45 years seeking reproductive health care during COVID-19. Two cross-sections of survey data were collected in July 2020 and January 2021. This analysis included those who sought prenatal (n=1496) or postpartum (n=482) care during the pandemic. Among those who had a prenatal or postpartum telehealth visit, we used multivariable logistic regression to examine the association between a measure of perceived telehealth quality and openness to future telehealth visits, adjusting for sociodemographic characteristics. A total of 57.5% of prenatal and 52.9% of postpartum respondents had a telehealth appointment. Respondents agreed with most statements about the quality of their telehealth appointments, with ≥80% reporting that they were convenient, easy, safe, and provided good information. Lower-ranked quality items were related to visits feeling personal and the patient feeling cared for. A total of 35.2% of prenatal (n=816) and 43.3% of postpartum (n=231) respondents expressed openness to telehealth visits in the future. Prenatal and postpartum respondents reporting higher telehealth quality had increased odds of being open to telehealth in the future (prenatal: adjusted odds ratio, 1.2; 95% confidence interval, 1.2–1.3; postpartum: adjusted odds ratio, 1.2; 95% confidence interval, 1.1–1.3). Prenatal and postpartum respondents with better telehealth experiences were more likely to express openness to telehealth in the future, although most preferred future in-person visits. As pregnancy-related telehealth continues, it is important to offer appointment options that match patient preferences, especially populations that face barriers in access to care, and to explore ways to personalize care and support positive patient–provider relationships.