Who Is (and Is Not) Receiving Telemedicine Care During the COVID-19 Pandemic.
Who Is (and Is Not) Receiving Telemedicine Care During the COVID-19 Pandemic.
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DOI：
10.1016/j.amepre.2021.01.030
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发表时间：
2021-09
影响因子：
5.5
通讯作者：
Whaley CM
中科院分区：
文献类型：
--
作者：
Cantor JH;McBain RK;Pera MF;Bravata DM;Whaley CM
2019冠状病毒病大流行迫使远程医疗成为患者与其提供者互动的主要方式。令人担忧的是，这一流行病将加剧整体医疗保健利用率和远程医疗利用率方面的现有差距。很少有全国性的研究考察了2019冠状病毒病大流行期间远程医疗使用的变化。2020年收集了2020年和2019年分别有680万和640万名基于雇主的健康计划受益人的数据。在宣布COVID-19大流行为国家紧急状态的一周前后，对未经调整的比率进行了比较。每周利用率的趋势也进行了检查，使用差异中的差异回归框架，以量化远程医疗和基于办公室的护理利用率的变化，同时控制患者的人口统计学和县级社会人口统计学措施。所有分析均于二零二零年进行。据观察，2020年3月13日之后，远程医疗利用率增加了20倍以上。相反，在办公室就诊的发生率下降了近50%，并且没有被远程医疗的增加完全抵消。远程医疗在低贫困水平县的患者（β=31.70，95% CI=15.17，48.23）、大都市地区的患者（β=40.60，95% CI=30.86，50.34）和成人中的增幅最大，而在0-12岁儿童中增幅最大（β=57.91，95% CI=50.32，65.49）。2019冠状病毒病大流行对远程医疗的利用率产生了不成比例的影响，这与患者年龄以及县级贫困率和城市化程度有关。
The COVID-19 pandemic has forced telehealth to be the primary means through which patients interact with their providers. There is a concern that the pandemic will exacerbate the existing disparities in overall healthcare utilization and telehealth utilization. Few national studies have examined the changes in telehealth use during the COVID-19 pandemic. Data on 6.8 and 6.4 million employer-based health plan beneficiaries in 2020 and 2019, respectively, were collected in 2020. Unadjusted rates were compared both before and after the week of the declaration of the COVID-19 pandemic as a national emergency. Trends in weekly utilization were also examined using a difference-in-differences regression framework to quantify the changes in telemedicine and office-based care utilization while controlling for the patient's demographic and county-level sociodemographic measures. All analyses were conducted in 2020. More than a 20-fold increase in the incidence of telemedicine utilization after March 13, 2020 was observed. Conversely, the incidence of office-based encounters declined by almost 50% and was not fully offset by the increase in telemedicine. The increase in telemedicine was greatest among patients in counties with low poverty levels (β=31.70, 95% CI=15.17, 48.23), among patients in metropolitan areas (β=40.60, 95% CI=30.86, 50.34), and among adults than among children aged 0–12 years (β=57.91, 95% CI=50.32, 65.49). The COVID-19 pandemic has affected telehealth utilization disproportionately on the basis of patient age and both the county-level poverty rate and urbanicity.
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影响因子：
4.7
作者：
Jetty, Anuradha;Moore, Miranda A.;Bazemore, Andrew
通讯作者：
Bazemore, Andrew
DOI：
10.1093/jamia/ocaa072
发表时间：
2020-07-01
影响因子：
6.4
作者：
Mann, Devin M.;Chen, Ji;Nov, Oded
通讯作者：
Nov, Oded
DOI：
10.15585/mmwr.mm6927a3
发表时间：
2020-07-10
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Hsu HE;Ashe EM;Silverstein M;Hofman M;Lange SJ;Razzaghi H;Mishuris RG;Davidoff R;Parker EM;Penman-Aguilar A;Clarke KEN;Goldman A;James TL;Jacobson K;Lasser KE;Xuan Z;Peacock G;Dowling NF;Goodman AB
通讯作者：
Goodman AB
影响因子：
13.8
作者：
Whaley CM;Pera MF;Cantor J;Chang J;Velasco J;Hagg HK;Sood N;Bravata DM
通讯作者：
Bravata DM
影响因子：
5.9
作者：
James MK;Kishore M;Lee SW
通讯作者：
Lee SW