1 Robert Graham Center , Washington, District of Columbia.
2 Department of Family and Preventive Medicine, Emory University , Atlanta, Georgia .
Telemed J E Health. 2018 Apr;24(4):268-276. doi: 10.1089/tmj.2017.0161. Epub 2017 Aug 14.
Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients.
Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption.
Nationally representative randomly sampled survey of 5,000 FPs.
Among the 31.3% of survey recipients who completed the survey, 83% practiced in urban areas and 17% in rural locations. Rural FPs were twice as likely to use telehealth as urban FPs (22% vs. 10%). Logistic regressions showed rural FPs had greater odds of reporting telehealth use to connect their patients to specialists and to care for their patients. Rural FPs were less likely to identify liability concerns as a barrier to using telehealth.
Telemedicine allows rural patients to see specialists without leaving their communities and permits rural FPs to take advantage of specialist expertise, expand their scope of practice, and reduce the feeling of isolation experienced by rural physicians.
Efforts to raise awareness of current payment policies for telehealth services, addressing the limitations of current reimbursement policies and state regulations, and creating new avenues for telehealth reimbursement and technological investments are critical to increasing primary care physician use of telehealth services.
远程医疗通过增加患者与医生和专家的接触机会以及减少患者的出行时间,有可能减少农村地区的健康不平等现象并改善农村人口的健康结果。
尽管农村远程医疗服务在几个专业领域有所扩展,但对于农村美国初级保健医生对远程医疗使用的态度、信念和接受程度知之甚少。本研究描述了农村和城市家庭医生(FPs)之间的差异,他们对远程医疗使用的看法以及进一步采用的障碍。
对 5000 名 FP 进行全国代表性随机抽样调查。
在完成调查的调查对象中,有 31.3%的人居住在城市地区,17%的人居住在农村地区。农村 FPs 使用远程医疗的可能性是城市 FPs 的两倍(22%对 10%)。逻辑回归显示,农村 FPs 更有可能报告使用远程医疗来将其患者与专家联系起来并照顾其患者。农村 FPs 不太可能将责任问题视为使用远程医疗的障碍。
远程医疗使农村患者无需离开社区即可看专科医生,并使农村 FPs 能够利用专科医生的专业知识,扩大其执业范围,并减少农村医生所经历的孤立感。
努力提高对远程医疗服务当前支付政策的认识,解决当前报销政策和州法规的局限性,并为远程医疗报销和技术投资开辟新途径,对于增加初级保健医生对远程医疗服务的使用至关重要。