Ching-Ching Claire Lin (
Anne Dievler is a senior advisor in the Office of Planning, Analysis, and Evaluation, HRSA.
Health Aff (Millwood). 2018 Dec;37(12):1967-1974. doi: 10.1377/hlthaff.2018.05125.
Telehealth services have the potential to improve access to care, especially in rural or urban areas with scarce health care resources. Despite the potential benefits, telehealth has not been fully adopted by health centers. This study examined factors associated with and barriers to telehealth use by federally funded health centers. We analyzed data for 2016 from the Uniform Data System using a mixed-methods approach. Our findings suggest that rural location, operational factors, patient demographic characteristics, and reimbursement policies influence health centers' decisions about using telehealth. Cost, reimbursement, and technical issues were described as major barriers. Medicaid reimbursement policies promoting live video and store-and-forward services were associated with a greater likelihood of telehealth adoption. Many health centers were implementing telehealth or exploring its use. Our findings identified areas that policy makers can address to achieve greater telehealth adoption by health centers.
远程医疗服务有改善医疗服务可及性的潜力,特别是在农村或城市地区,这些地区医疗资源稀缺。尽管远程医疗具有潜在的好处,但它尚未被健康中心充分采用。本研究调查了与联邦资助的健康中心使用远程医疗相关的因素和障碍。我们使用混合方法分析了 2016 年来自统一数据系统的数据。我们的研究结果表明,农村地理位置、运营因素、患者人口统计学特征和报销政策影响了健康中心使用远程医疗的决策。成本、报销和技术问题被描述为主要障碍。促进实时视频和存储转发服务的医疗补助报销政策与采用远程医疗的可能性更大相关。许多健康中心正在实施远程医疗或探索其使用。我们的研究结果确定了政策制定者可以解决的领域,以实现健康中心更广泛地采用远程医疗。