Jiani Yu (
Pamela J. Mink is the director of health services research, Health Economics Program, Minnesota Department of Health, in St. Paul.
Health Aff (Millwood). 2018 Dec;37(12):1931-1939. doi: 10.1377/hlthaff.2018.05116.
In recent years state and federal policies have encouraged the use of telemedicine by formalizing payments for it. Telemedicine has the potential to expand access to timely care and reduce costs, relative to in-person care. Using information from the Minnesota All Payer Claims Database, we conducted a population-level analysis of telemedicine service provision in the period 2010-15, documenting variation in provision by coverage type, provider type, and rurality of patient residence. During this period the number of telemedicine visits increased from 11,113 to 86,238, and rates of use varied extensively by coverage type and rurality. In metropolitan areas telemedicine visits were primarily direct-to-consumer services provided by nurse practitioners or physician assistants and covered by commercial insurance. In nonmetropolitan areas telemedicine use was chiefly real-time provider-initiated services delivered by physicians to publicly insured populations. Recent federal and state legislation that expanded coverage and increased provider reimbursement for telemedicine services could lead to expanded use of telemedicine, including novel approaches in new patient populations.
近年来，州和联邦政策通过规范远程医疗的支付方式鼓励其使用。与面对面护理相比，远程医疗有潜力扩大及时护理的可及性并降低成本。我们利用来自明尼苏达州全支付者索赔数据库的信息，对 2010-15 年期间远程医疗服务的提供情况进行了人群水平分析，记录了按覆盖类型、提供者类型和患者居住地农村程度的服务提供情况的差异。在此期间，远程医疗访问量从 11,113 次增加到 86,238 次，使用率因覆盖类型和农村程度而有很大差异。在大都市地区，远程医疗访问主要是由执业护士或医师助理提供的直接面向消费者的服务，并由商业保险覆盖。在非大都市地区，远程医疗的使用主要是医生为公共保险人群提供的实时服务。最近联邦和州的立法扩大了远程医疗服务的覆盖范围，并增加了提供者的报销，这可能导致远程医疗的使用增加，包括在新的患者群体中采用新的方法。
