The Association of Broadband Internet Access and Telemedicine Utilization in rural Western Tennessee: an observational study.
The Association of Broadband Internet Access and Telemedicine Utilization in rural Western Tennessee: an observational study.
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DOI：
10.1186/s12913-021-06746-0
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发表时间：
2021-08-03
影响因子：
2.8
通讯作者：
Pirtle CJ
中科院分区：
文献类型：
--
作者：
Quinton JK;Ong MK;Vangala S;Tetleton-Burns A;Webb A;Sarkisian C;Casillas A;Kakani P;Han M;Pirtle CJ
宽带接入已被强调为改善农村社区获得护理机会的国家政策优先事项。以确定宽带互联网的可用性是否与田纳西州西部农村患者人口采用远程医疗有关。2019年3月13日至2021年3月13日使用电子病历数据进行的观察性研究。多变量Logistic回归结合了个人水平的特征，以及邮政编码水平的宽带可用性、收入、教育程度和初级保健医生的供应，以及县级决定的农村状况。田纳西州西部的单一医疗系统。2019年3月13日至2021年3月13日期间在田纳西州西部医疗系统中有一次或多次面对面或远程接触并居住在田纳西州西部的成年患者(N= 54,688)。在2020年3月13日之后的一年内完成一次或多次视频会面(N= 3199；7%)。我们感兴趣的主要特征是每个邮政编码中能够接入互联网的居民比例符合联邦通信委员会对宽带接入的定义，并根据年龄、性别、种族、收入、教育程度、保险类型、农村状况和初级保健提供者的供应进行调整。田纳西州西部农村卫生系统的患者主要是白人(79%)，居住在农村邮政编码(73%)，家庭收入中位数(52,085美元)低于州和全国平均水平。居住在80%到100%宽带接入的邮政编码地区的患者在2020年3月13日之后的一年中更有可能同时完成远程医疗和面对面访问([OR；95%CI]1.57；1.29，1.94)，只完成远程医疗访问(2.26；1.71，2.97)，不太可能只完成面对面访问(0.81；0.74，0.89)，但不会更多或更少地访问不需要护理的可能性(1.07；0.97，1.18)。宽带互联网的可用性被证明是2020年3月13日之后农村工人阶级社区使用远程医疗的众多因素之一。宽带互联网的接入是农村社区患者获得远程医疗的一个决定因素，对于有意改善农村患者的健康和获得护理机会的政策制定者来说，这应该是一个优先事项。网上版载有补充材料，可在10.1186/s12913-021-06746-0查阅。
Broadband access has been highlighted as a national policy priority to improve access to care in rural communities. To determine whether broadband internet availability was associated with telemedicine adoption among a rural patient population in western Tennessee. Observational study using electronic medical record data from March 13th, 2019 to March 13th, 2021. Multivariable logistic regression incorporating individual-level characteristics with broadband availability, income, educational attainment, and primary care physician supply at the zip code level, and rural status as determined at the county level. Single health system in western Tennessee. Adult patients with one or more in-person or remote encounter in a health system in western Tennessee and residing in western Tennessee between March 13th, 2019 and March 13th, 2021 (N = 54,688). Completion of one or more video encounters in the year following March 13th, 2020 (N = 3199; 7%). Our primary characteristic of interest was the proportion of residents in each zip code with access to the internet meeting the Federal Communications Commission definition of broadband access, adjusting for age, gender, race, income, educational attainment, insurance type, rural status, and primary care provider supply. Patients in a rural western Tennessee health system were predominantly white (79%), residing in rural zip codes (73%) with median household incomes ($52,085) less than state and national averages. Patients residing in a zip code where there is 80 to 100% broadband access compared to 0 to 20% were more likely in the year following March 13th, 2020 to have completed both telemedicine and in-person visits ([OR; 95% CI] 1.57; 1.29, 1.94), completed only telemedicine visits (2.26; 1.71, 2.97), less likely to have only completed in-person visits (0.81; 0.74, 0.89), but no more or less likely to have accessed no care (1.07; 0.97, 1.18). The availability of broadband internet was shown to be one of many factors associated with the utilization of telemedicine for a rural, working-class community after March 13th, 2020. Access to broadband internet is a determinant of access to telemedicine for patients in rural communities and should be a priority for policymakers interested in improving health and access to care for rural patients. The online version contains supplementary material available at 10.1186/s12913-021-06746-0.
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影响因子：
24.9
作者：
Garcia, Macarena C.;Faul, Mark;Iademarco, Michael F.
通讯作者：
Iademarco, Michael F.
影响因子：
2.9
作者：
Ryu S
通讯作者：
Ryu S
影响因子：
2.3
作者：
Lewiecki, E. Michael;Rochelle, Rachelle
通讯作者：
Rochelle, Rachelle
DOI：
10.1377/hlthaff.2020.01786
发表时间：
2021-03
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Patel SY;Mehrotra A;Huskamp HA;Uscher-Pines L;Ganguli I;Barnett ML
通讯作者：
Barnett ML
影响因子：
9.7
作者：
Hung, Peiyin;Henning-Smith, Carrie E.;Kozhimannil, Katy B.
通讯作者：
Kozhimannil, Katy B.