Perspectives of Physicians with Experience in Nursing Home Care on Telehealth Use During the COVID-19 Public Health Emergency.
Perspectives of Physicians with Experience in Nursing Home Care on Telehealth Use During the COVID-19 Public Health Emergency.
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DOI：
10.1007/s11606-023-08087-6
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发表时间：
2023-05
影响因子：
5.7
通讯作者：
Jung, Hye-Young
中科院分区：
文献类型：
--
作者：
Yu, Jiani;Yun, Hyunkyung;Unruh, Mark A.;O'Donnell, Eloise M.;Katz, Paul R.;Ancker, Jessica S.;Jung, Hye-Young
尽管在2019冠状病毒病突发公共卫生事件期间，养老院（NHs）的医疗保险受益人获得远程医疗服务的机会扩大了，但缺乏医生对向养老院居民提供远程医疗的可行性和挑战的看法的信息。检查医生对在NHs中提供远程医疗的适当性和挑战的观点。NHs的医疗主管或主治医师。从2021年1月18日至1月29日，我们对美国医学董事协会的成员进行了35次半结构化访谈。专题分析的结果反映了在NH护理中经验丰富的医生对远程医疗使用的看法。参与者在国民保健制度中使用远程医疗的程度，对国民保健制度居民的远程医疗的感知价值，以及远程医疗提供的障碍。参与者包括7名内科医生（20.0%）、8名家庭医生（22.9%）和18名老年医生（51.4%）。出现了五个共同的主题：(1)需要直接护理，以充分照顾国民保健制度的居民；(2)远程医疗可以让医生在下班时间和其他医生不容易接触到病人的情况下更灵活地接触到NH居民；(3) NH工作人员和其他组织资源对远程保健的成功至关重要，但工作人员的时间是提供远程保健的主要障碍；(4)国家医疗服务体系中远程医疗的适当性可能仅限于某些常住人口和/或服务；(5)关于远程医疗的使用是否会在NHs持续一段时间的相互矛盾的观点。分主题包括住院医生关系在促进远程医疗中的作用以及远程医疗对认知障碍住院医生的适宜性。与会者对国民保健制度中远程保健的有效性看法不一。促进远程保健的工作人员资源和对新罕布什尔州居民的远程保健的限制是提出最多的问题。这些发现表明，NHs的医生可能不认为远程医疗是大多数面对面服务的合适替代品。在线版本包含补充资料，网址为10.1007/s11606-023-08087-6。
Despite expanded access to telehealth services for Medicare beneficiaries in nursing homes (NHs) during the COVID-19 public health emergency, information on physicians’ perspectives on the feasibility and challenges of telehealth provision for NH residents is lacking. To examine physicians’ perspectives on the appropriateness and challenges of providing telehealth in NHs. Medical directors or attending physicians in NHs. We conducted 35 semistructured interviews with members of the American Medical Directors Association from January 18 through January 29, 2021. Outcomes of the thematic analysis reflected perspectives of physicians experienced in NH care on telehealth use. The extent to which participants used telehealth in NHs, the perceived value of telehealth for NH residents, and barriers to telehealth provision. Participants included 7 (20.0%) internists, 8 (22.9%) family physicians, and 18 (51.4%) geriatricians. Five common themes emerged: (1) direct care is needed to adequately care for residents in NHs; (2) telehealth may allow physicians to reach NH residents more flexibly during offsite hours and other scenarios when physicians cannot easily reach patients; (3) NH staff and other organizational resources are critical to the success of telehealth, but staff time is a major barrier to telehealth provision; (4) appropriateness of telehealth in NHs may be limited to certain resident populations and/or services; (5) conflicting views about whether telehealth use will be sustained over time in NHs. Subthemes included the role of resident-physician relationships in facilitating telehealth and the appropriateness of telehealth for residents with cognitive impairment. Participants had mixed views on the effectiveness of telehealth in NHs. Staff resources to facilitate telehealth and the limitations of telehealth for NH residents were the most raised issues. These findings suggest that physicians in NHs may not view telehealth as a suitable substitute for most in-person services. The online version contains supplementary material available at 10.1007/s11606-023-08087-6.
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DOI：
10.1377/hlthaff.2020.00957
发表时间：
2021-03
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Gandhi A;Yu H;Grabowski DC
通讯作者：
Grabowski DC
影响因子：
5.2
作者：
Seifert A;Batsis JA;Smith AC
通讯作者：
Smith AC
影响因子：
9.7
作者：
Dearing, James W.;Cox, Jeffrey G.
通讯作者：
Cox, Jeffrey G.
影响因子：
3
作者：
Driessen, Julia;Castle, Nicholas G.;Handler, Steven M.
通讯作者：
Handler, Steven M.
DOI：
10.1016/j.jamda.2020.03.003
发表时间：
2020-08-01
影响因子：
7.6
作者：
Helmer-Smith, Mary;Fung, Celeste;Liddy, Clare
通讯作者：
Liddy, Clare