Advancing health equity and access using telemedicine: a geospatial assessment
Advancing health equity and access using telemedicine: a geospatial assessment
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DOI：
10.1093/jamia/ocz108
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发表时间：
2019-08-01
影响因子：
6.4
通讯作者：
Shyu, Chi-Ren
中科院分区：
文献类型：
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作者：
Khairat, Saif;Haithcoat, Timothy;Shyu, Chi-Ren
引言：健康差距影响着城乡居民，有证据表明，农村居民的健康状况明显低于城市居民。健康公平是对缩小健康及其决定因素(包括社会决定因素)差距的承诺。目的：本文评估虚拟紧急护理(VUC)项目在健康公平和可获得性方面的覆盖范围和背景，重点关注农村服务不足的人群。材料和方法：我们研究了虚拟紧急护理(VUC)在前4个季度收集的5343名患者激活记录和2195次独特接触。以邮政编码为分析单位，地理空间分析和信息学将结果量化。结果：根据每个邮政编码计算的11个健康公平性和可及性决定因素的平均累积分数，对覆盖范围和背景进行评估。对VUC使用者、北卡罗来纳州(NC)、农村NC和城市NC的平均结果进行了比较。结论：研究结论：通过利用VUC，来自农村地区面临不平等的患者能够更好地获得医疗保健。通过地理空间分析，概述了帮助改善农村服务不足人口获得医疗保健的机会的建议。
Introduction: Health disparity affects both urban and rural residents, with evidence showing that rural residents have significantly lower health status than urban residents. Health equity is the commitment to reducing disparities in health and in its determinants, including social determinants.Objective: This article evaluates the reach and context of a virtual urgent care (VUC) program on health equity and accessibility with a focus on the rural underserved population.Materials and Methods: We studied a total of 5343 patient activation records and 2195 unique encounters collected from a VUC during the first 4 quarters of operation. Zip codes served as the analysis unit and geospatial analysis and informatics quantified the results.Results: The reach and context were assessed using a mean accumulated score based on 11 health equity and accessibility determinants calculated for each zip code. Results were compared among VUC users, North Carolina (NC), rural NC, and urban NC averages.Conclusions: The study concluded that patients facing inequities from rural areas were enabled better healthcare access by utilizing the VUC. Through geospatial analysis, recommendations are outlined to help improve healthcare access to rural underserved populations.