告知高风险初级保健患者选择围绕远程医疗使用的因素:一个框架
John W Morgan1,2, Mandy K Salmon3, Maya Ambady4,5
1Leonard Davis Institute at the University of Pennsylvania, Philadelphia, PA, USA. jwmorgan88@gmail.com.
Journal of general internal medicine
|November 8, 2023
概括
高风险患者在选择远程医疗时考虑了访问实用性和成本,但背景和情境因素也显著影响了他们对初级保健的决定. 了解这些要素是改善远程医疗服务获取的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 远程医疗在流行后的初级保健中的作用正在发展,特别是在高风险人群中.
- 患者对远程医疗的偏好各不相同,需要了解影响因素.
- 基于价值的护理模式强调预防和慢性疾病管理,远程医疗可能发挥作用.
研究的目的:
- 探索影响高风险初级保健患者关于远程医疗,办公室访问或延迟护理的决定的因素.
- 确定患者在不同初级保健模式之间选择的观点.
- 为优化在初级保健中的远程医疗利用策略提供信息.
主要方法:
- 使用半结构化的电话采访进行定性,横截面研究.
- 29名高风险初级保健患者的便利样本.
- 有根据的理论和不断的比较分析以确定主题.
主要成果:
- 四个主要主题出现了:感知效用,潜在成本 (时间,金钱,努力,安全),修饰因素 (临床情况,可用性) 和驱动因素 (背景,数字环境).
- 患者对远程医疗的选择受到这些因素的复杂相互作用的影响.
- 开发了一个新的框架,说明患者在远程医疗使用中的选择.
结论:
- 感知到的效用和成本是主要的驱动因素,但修饰因素和驱动因素对远程医疗使用的决策有重大影响.
- 了解这些细微因素对于政策制定者,支付者和卫生系统来说至关重要.
- 可以制定战略,以加强高风险人群中公平和高价值的远程医疗采用.
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