远程医疗访问美国熟练护理机构
Agne Ulyte1, Ateev Mehrotra1,2, Andrew D Wilcock1
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
JAMA network open
|August 18, 2023
概括
在熟练护理机构 (SNFs) 中,远程医疗的使用在疫情期间激增,但随后下降. 较高的SNF远程医疗使用改善了对精神病学服务的访问,这表明需要制定政策来支持其持续采用.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
背景情况:
- 熟练护理设施 (SNFs) 在及时提供护理方面面临挑战.
- 远程医疗提供了一个潜在的解决方案,以改善在SNFs的护理获取和及时性.
- 虽然COVID-19大流行加速了远程医疗的普及,但它对SNF的长期模式仍然不清楚.
研究的目的:
- 描述技术护理机构 (SNF) 中远程医疗利用的模式.
- 分析COVID-19大流行之前和之后SNF中远程医疗使用的变化.
- 调查远程医疗使用与在国家医疗基金中获得特定医疗保健服务之间的联系.
主要方法:
- 一项分析医疗保险服务费索赔和2018-2022年MDS 3.0数据的队列研究.
- 包括15,434个SNF和超过440万居民,区分常规SNF访问和其他门诊访问.
- 采用差异差异方法来评估基于SNF远程医疗使用水平的访问类型的变化.
主要成果:
- 在SNF的远程医疗访问从0.15% (大流行前) 增加到15% (2020年5月),然后到2022年降至2%.
- 远程医疗使用量较高的设施更有可能是农村地区的,并且精神病医疗访问量显著增加.
- 对于移动性问题或新专家咨询的住户的门诊访问,观察到的变化有限.
结论:
- 在SNF中采用远程医疗在2020年升,但稳定在高于大流行前的水平.
- 在SNF中增加远程医疗的使用与更好地获得精神病治疗有关.
- 鼓励继续使用远程医疗的政策可以随着技术的发展,提高获得基本服务的机会.
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