Moore Miranda A, Coffman Megan, Jetty Anuradha, Klink Kathleen, Petterson Stephen, Bazemore Andrew
From the Department of Family and Preventive Medicine, Emory University, Atlanta, GA (MAM); the Robert Graham Center, Washington, DC (MC, AJ, SP, AB); and the Office of Academic Affiliations, Department of Veterans Affairs (KK).
J Am Board Fam Med. 2017 May-Jun;30(3):320-330. doi: 10.3122/jabfm.2017.03.160201.
Little is known about the attitudes toward and adoption of telehealth services among family physicians (FPs), the largest primary care physician group. We conducted a national survey of FPs, randomly sampled from membership organization files, to investigate use of and barriers to using telehealth services.
Using bivariate analyses, we examined how telehealth usage affected FPs' identified barriers to using telehealth services. Logistic regressions show the factors associated both with using telehealth services and with barriers to using telehealth services.
Surveys reached 4980 FPs; 1557 surveys were eligible for analysis (31% response rate). Among FPs, 15% reported using telehealth services during 2014. After controlling for the characteristics of the physicians and their practice, FPs who were based in a rural setting, worked in a practice owned by an integrated health system or other ownership structure, and provided hospital/urgent/emergency care were more likely to use telehealth. Physician and practice characteristics by telehealth use status, sex of the physician, practice location, years in practice, care provided, and practice ownership were associated with the barriers identified.
Telehealth use was limited among FPs. Many of the barriers to using telehealth services cited by FPs are amenable to policy modification.
作为最大的基层医疗医生群体,家庭医生(FPs)对远程医疗服务的态度及采用情况鲜为人知。我们对从会员组织档案中随机抽取的家庭医生进行了一项全国性调查,以调查远程医疗服务的使用情况及使用障碍。
我们采用双变量分析,研究远程医疗的使用如何影响家庭医生所确定的使用远程医疗服务的障碍。逻辑回归显示了与使用远程医疗服务以及与使用远程医疗服务的障碍相关的因素。
共向4980名家庭医生发放了调查问卷;1557份调查问卷符合分析条件(回复率为31%)。在家庭医生中,15%报告在2014年期间使用过远程医疗服务。在控制了医生及其执业机构的特征后,在农村地区执业、在综合医疗系统或其他所有制结构拥有的机构工作以及提供医院/紧急/急诊护理的家庭医生更有可能使用远程医疗。根据远程医疗使用状况、医生性别、执业地点、执业年限、提供的护理以及执业机构所有制划分的医生和执业机构特征与所确定的障碍相关。
家庭医生对远程医疗的使用有限。家庭医生提到的许多使用远程医疗服务的障碍都可以通过政策调整来解决。