在COVID-19之前和期间,远程医疗扩张,互联网速度和初级保健接入
Alyssa Shell Tilhou1, Arjun Jain2, Thomas DeLeire3
1Boston University Medical Center, Boston, Massachusetts.
JAMA network open
|January 5, 2024
概括
公共卫生紧急情况 (PHE) 期间远程医疗的扩张增加了初级保健 (PC) 的使用,特别是在某些人口群体中. 然而,高速互联网 (HSI) 访问并没有消除利用差异,这表明远程医疗可能无法消除所有PC访问差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康 公平数字健康
- 获得初级保健 获得初级保健
背景情况:
- 初级保健 (PC) 与改善的健康结果有关.
- 远程医疗扩张和互联网速度对不同人群的PC使用的影响仍然不清楚.
- 了解这些关联对于公平的医疗保健服务至关重要.
研究的目的:
- 调查远程医疗采用和互联网速度与初级保健使用之间的关系.
- 为了分析这些协会在各种社会人口统计学因素影响健康.
主要方法:
- 一项队列研究分析了威斯康星州医疗补助受益者 (18-64岁) 使用差异回归.
- 数据比较了COVID-19公共卫生紧急情况 (PHE) 之前和期间的初级保健访问 (面对面和远程医疗).
- 高速互联网 (HSI) 是通过人口普查区组宽带速度来定义的;远程医疗使用是通过CPT代码来衡量的.
主要成果:
- 在PHE期间,大多数人口群体的远程医疗普及率显著增加,尽管PHE前使用率较低,但西班牙裔和非西班牙裔黑人人群体的高采用率是显著的例外.
- 与那些使用高速互联网 (HSI) 的参与者相比,与那些使用低速互联网 (LSI) 的参与者相比,远程医疗访问的增加更大.
- 尽管远程医疗的使用增加了,但HSI访问并没有缓解不同社会人口群体之间现有的使用差异.
结论:
- 在PHE期间的远程医疗扩张促进了初级保健的使用,特别是在PHE前参与度较高的群体中.
- 虽然远程医疗和HSI可能会增强PC接入,但它们并没有完全消除健康社会人口统计学决定因素的现有利用差距.
- 需要进一步的战略来确保所有人均获得平等的初级保健服务.
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