A national survey of telemedicine use by US emergency departments
A national survey of telemedicine use by US emergency departments
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DOI：
10.1177/1357633x18816112
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发表时间：
2020-06-01
影响因子：
4.7
通讯作者：
Camargo, Carlos A.
中科院分区：
文献类型：
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作者：
Zachrison, Kori S.;Boggs, Krislyn M.;Camargo, Carlos A.
目的远程医疗有可能改善紧急医疗服务的提供：然而，其在美国（US）急诊部门的采用程度尚不清楚。我们的目标是确定美国所有急诊科中远程医疗使用的流行程度，描述最常用的临床应用，并确定与其使用相关的急诊科特征。方法作为美国国家急诊科目录调查的一部分，我们查询了2016年开放的所有5375家美国急诊科。多变量逻辑回归分析确定了与急诊科接受远程医疗服务相关的特征。结果总体而言，4507急诊科（84%）回应了我们的调查，4031回答了两个远程医疗问题（75%）。尽管2016年有1694个急诊科（42%）报告没有远程医疗，但大多数急诊科都有：1923个（48%）急诊科接受了远程医疗服务，149个（4%）急诊科接受了远程医疗服务，并在提供远程医疗的医院，265个急诊科（7%）没有接受远程医疗，但在提供远程医疗服务的医院。在接受远程医疗的急诊部门中，最常见的应用是中风/神经病学（76%），精神病学（38%）和儿科（15%）。在多变量分析中，接受远程医疗的急诊部门的成人年总就诊量较高，儿童年总就诊量较低;不太可能是学术性或独立性的;并且因地区而异。在多变量分析中，提供远程医疗的医院急诊科的成人和儿童年总就诊量较高，更有可能是学术性的，不太可能是独立的。2016年，远程医疗在大多数美国急诊科（58%）中使用，尤其是中风/神经病学和精神病学。未来的研究需要了解远程医疗在不同临床应用中的价值，以及实施远程医疗的障碍。
Objective Telemedicine has the potential to improve the delivery of emergency medical care: however, the extent of its adoption in United States (US) emergency departments is not known. Our objective was to characterise the prevalence of telemedicine use among all US emergency departments, describe clinical applications for which it is most commonly used, and identify emergency department characteristics associated with its use. Methods As part of the National Emergency Department Inventory-USA survey, we queried all 5375 US emergency departments open in 2016. Multivariable logistic regression analyses identified characteristics associated with emergency department receipt of telemedicine services. Results Overall, 4507 emergency departments (84%) responded to our survey, with 4031 responding to both telemedicine questions (75%). Although 1694 emergency departments (42%) reported no telemedicine in 2016, most did: 1923 (48%) emergency departments received telemedicine services, 149 (4%) emergency departments received telemedicine services and were in hospitals that provided telemedicine, and 265 emergency departments (7%) did not receive telemedicine but were in hospitals that provided telemedicine services. Among emergency departments receiving telemedicine, the most common applications were stroke/neurology (76%), psychiatry (38%), and paediatrics (15%). In multivariable analysis, telemedicine-receiving emergency departments had higher annual total visit volume for adults and lower annual total visit volume by children; were less likely to be academic or freestanding; and varied by region. In multivariable analysis, emergency departments in telemedicine-providing hospitals had higher annual total visit volume for adults and children, were more likely to be academic and were less likely to be freestanding. Conclusion In 2016, telemedicine was used in most US emergency departments (58%), especially for stroke/neurology and psychiatry. Future research is needed to understand the value of telemedicine for different clinical applications, and the barriers to its implementation.