初级保健远程医疗和传统医疗保险中的患者利用,质量和支出
Derek T Lake1, Jiani Yu2, Lawrence P Casalino2,3
1Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA. Del2018@med.cornell.edu.
Journal of general internal medicine
|February 24, 2026
概括
增加的初级保健远程医疗使用减少了面对面的访问,但总访问量略有增加,而不会影响传统医疗保险受益人的住院治疗或医疗保健支出.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 数字健康数字健康
背景情况:
- COVID-19公共卫生紧急情况扩大了传统医疗保险 (TM) 受益人的远程医疗覆盖范围.
- 越来越多的远程医疗对初级保健使用率,支出和结果的影响仍然不清楚.
研究的目的:
- 检查初级保健远程医疗服务的提供水平如何影响医疗保健利用率,支出和患者的结果.
- 调查高与低远程医疗 E&M 访问量和关键医疗保健指标之间的关联.
主要方法:
- 使用差异差异设计的回顾性队列研究.
- 比较疫情前的结果 (2019年) 与远程医疗后的扩张 (2020-2022年).
- 分析了20%的MT受益者的全国样本,比较高与低的远程医疗初级保健实践.
主要成果:
- 高水平的远程医疗实践显示,面对面的E&M访问减少了 (-0.86/患者/年),但总的E&M访问增加了 (0.10/患者/年).
- 观察到的ED访问总数 (0.02/患者/年) 和可预防的ED访问 (0.01/患者/年) 的适度增加.
- 医院住院,门诊护理敏感入院或整体医疗保健支出没有显著变化.
结论:
- 较高的初级保健远程医疗采用与较少的面对面访问和总体E&M访问的微小净增加相关.
- 远程医疗的扩张并没有显著改变住院率或医疗保健总支出.
- 调查结果表明,远程医疗可以改变访问模式,而不会广泛影响主要的医疗保健利用率或成本指标.
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