地域による医療情報技術の採用 米国病院の社会経済的欠乏
Alice S Yan1,2,3, Nate C Apathy1,4,5, Jie Chen1,2,3,5
1Department of Health Policy and Management, School of Public Health, University of Maryland, College Park.
JAMA health forum
|September 5, 2025
まとめ
社会経済的に恵まれない地域の病院は,テレヘルスと健康情報交換 (HIE) を含む健康情報技術 (HIT) を採用しない. しかし,全体的にHITの採用は2018年から2023年にかけて増加し,責任あるケア組織は格差を減らす可能性があります.
科学分野:
- 医療サービス研究
- 医療情報学
- 健康に関する公平性
背景:
- 社会経済的な地位は,医療へのアクセスと医療の質に大きな影響を与えます.
- 病院の医療情報技術 (HIT) の導入は,医療の格差を軽減する可能性があります.
- 病院は 恵まれない人々に 重要な役割を果たしています
研究 の 目的:
- 遠隔医療と健康情報交換 (HIE) 機能の採用における格差を分析する.
- 病院サービスエリア (HSA) の社会経済的欠乏に基づくこれらの格差を調査する.
主な方法:
- アメリカン・ホスピタル・アソシエーションのデータ (2018-2023) をHSAレベルの地域欠乏指数と関連付ける横断的な研究.
- 非連邦急性ケア病院のHITアウトカムデータを含みます.
- 記述的,回帰,およびブラインダー-オアハカ分解法を用いた分析.
主要な成果:
- 最も社会経済的に恵まれないHSAの病院は,テレヘルスとHIE機能の採用率が著しく低いことを示しました.
- 2018年から2023年の間,すべてのHSA欠乏レベルにおいてHITの採用が著しく増加しました.
- 病院のベッドのサイズ,都市/農村の位置,ACOの参加は,採用の格差の顕著な部分を説明しました.
結論:
- 恵まれない地域では普及率が低いものの,テレヘルスとHIEの利用は着実に増加しています.
- アカウントブル・ケア・オーガナイゼーション (ACO) の参加は,HITのインフラストラクチャを強化することができます.
- ACOは,HITの採用と医療へのアクセスにおける地理的な格差を減らす可能性を示しています.
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