远程医疗模式对不同环境中的质量指标的影响:实施科学信息后期队列研究
Danielle Rome1, Alyssa Sales2, Talea Cornelius3
1Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States.
远程医疗,包括视频和电话访问,显示血压和抑郁症查的质量指标略低,与低收入环境中的亲自护理相比. 远程医疗的采用在两年内大幅下降.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 远程医疗服务是远程医疗服务.
背景情况:
- 基于视频的远程医疗在多样化,低社会经济地位 (SES) 的人群中未得到充分利用.
- 关于远程医疗模式 (视频与仅音频) 如何影响这些环境中的临床质量,目前的研究有限.
研究的目的:
- 评估远程医疗的采用和访问模式 (面对面,视频,电话) 对不同,低SES设置中的初级保健质量指标的影响.
- 应用实施科学框架 (RE-AIM) 来理解远程医疗集成.
主要方法:
- 利用RE-AIM框架来评估远程医疗的覆盖范围,有效性,采用,实施和维护.
- 在面对面,视频和电话访问中比较初级保健质量指标.
- 从提供者那里收集了关于远程医疗实施障碍和促进者的定性反.
主要成果:
- 与视频和电话访问相比,面对面的访问显示了血压和抑郁症查的质量指标略高.
- 在被研究的人群中,在两年内观察到远程医疗的不采用.
- 定性数据揭示了影响远程医疗实施的关键障碍和促进者.
结论:
- 远程医疗访问的模式可能会影响质量结果,特别是在历史上边缘化社区.
- 提供者和患者的偏好,以及技术挑战,是有效的远程医疗实施的关键考虑因素.
- 需要进一步的研究,以优化远程医疗战略在多样化和低资源的设置后的流行病.
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