Equity and use of telehealth modalities among people living with HIV during the COVID-19 pandemic.
Equity and use of telehealth modalities among people living with HIV during the COVID-19 pandemic.
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DOI：
10.1177/20552076231218840
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发表时间：
2023-01
期刊：
影响因子：
3.9
通讯作者：
Womack, Julie A.
中科院分区：
文献类型：
--
作者：
Carson, Hannah;Wang, Karen H.;Paek, Hyung;Hoffman, Pamela;Arakaki, Andrew;Gonzalez-Colaso, Rosana;Barakat, Lydia A.;Villanueva, Merceditas;Womack, Julie A.
COVID-19迫使人们迅速过渡到远程医疗。关于艾滋病毒感染者或有感染艾滋病毒风险者（PWH）使用电话与视频访问的情况知之甚少。我们研究了一个城市艾滋病诊所的电子健康记录数据。我们的样本包括访问和个人数据。访视层面的数据来自2020年3月30日至2020年5月31日的预约。个人水平数据来自18岁以上的患者，这些患者在关注期间至少完成了一次电话或视频访视。我们做了一个横截面分析。我们的主要结果是远程医疗模式（电话或视频）。我们比较了远程医疗模式的访视完成状态。我们使用逻辑回归评估患者特征与远程医疗模式之间的关联。总共有1742次访问包括远程医疗方式的信息：1432次电话访问（82%）和310次视频访问（18%）。电话访视完成率为77%，视频访视为75%（p = 0.449）。该诊所于2020年4月录得643次已完成的远程医疗就诊，5月则为623次。电话访问的比例从4月的84%下降到5月的79%（p = 0.031）。大多数患者参加了电话访视与视频访视（415 vs. 88例患者）。年龄较大（调整后的比值比[AOR] 3.28; 95%置信区间[CI]，1.37-7.82）和黑人（AOR 2.42; 95% CI，1.20-4.49）与电话访视呈正相关。患者门户网站入组（AOR 0.06; 95% CI，0.02-0.16）与电话访视呈负相关。威尔斯亲王医院使用电话就诊多于视频就诊，这表明电话就诊是这一人群的重要医疗资源。
COVID-19 forced a rapid transition to telehealth. Little is known about the use of telephone versus video visits among people living with or at risk for HIV (PWH). We studied electronic health record data from an urban HIV clinic. Our sample included visit- and person-level data. Visit-level data came from appointments scheduled from 30 March 2020 to 31 May 2020. Person-level data came from patients 18+ years of age who completed at least one telephone or video visit during the period of interest. We performed a cross-sectional analysis. Our primary outcome was telehealth modality (telephone or video). We compared visit completion status by telehealth modality. We evaluated associations between patient characteristics and telehealth modality using logistic regression. In total, 1742 visits included information on telehealth modality: 1432 telephone (82%) and 310 (18%) video visits. 77% of telephone visits were completed compared to 75% of video visits (p = 0.449). The clinic recorded 643 completed telehealth visits in April and 623 in May 2020. The proportion of telephone visits decreased from 84% in April to 79% in May (p = 0.031). Most patients participated in telephone versus video visits (415 vs. 88 patients). Older age (adjusted odds ratio [AOR] 3.28; 95% confidence interval [CI], 1.37–7.82) and Black race (AOR 2.42; 95% CI, 1.20–4.49) were positively associated with telephone visits. Patient portal enrollment (AOR 0.06; 95% CI, 0.02–0.16) was negatively associated with telephone visits. PWH used telephone more than video visits, suggesting that telephone visits are a vital healthcare resource for this population.
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