School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Am Med Inform Assoc. 2019 Aug 1;26(8-9):796-805. doi: 10.1093/jamia/ocz108.
Health disparity affects both urban and rural residents, with evidence showing that rural residents have significantly lower health status than urban residents. Health equity is the commitment to reducing disparities in health and in its determinants, including social determinants.
This article evaluates the reach and context of a virtual urgent care (VUC) program on health equity and accessibility with a focus on the rural underserved population.
We studied a total of 5343 patient activation records and 2195 unique encounters collected from a VUC during the first 4 quarters of operation. Zip codes served as the analysis unit and geospatial analysis and informatics quantified the results.
The reach and context were assessed using a mean accumulated score based on 11 health equity and accessibility determinants calculated for each zip code. Results were compared among VUC users, North Carolina (NC), rural NC, and urban NC averages.
The study concluded that patients facing inequities from rural areas were enabled better healthcare access by utilizing the VUC. Through geospatial analysis, recommendations are outlined to help improve healthcare access to rural underserved populations.
健康差距影响城市和农村居民，有证据表明，农村居民的健康状况明显低于城市居民。健康公平是承诺减少健康及其决定因素（包括社会决定因素）方面的差距。
本文评估了一个虚拟紧急护理（VUC）计划在健康公平和可及性方面的覆盖范围和背景，重点关注农村服务不足的人群。
我们研究了总共 5343 份患者激活记录和 2195 个独特的就诊记录，这些记录是在 VUC 运营的前 4 个季度中收集的。邮政编码作为分析单位，地理空间分析和信息学对结果进行量化。
使用为每个邮政编码计算的 11 个健康公平和可及性决定因素的平均累积分数评估覆盖范围和背景。将 VUC 用户、北卡罗来纳州（NC）、北卡罗来纳州农村地区和北卡罗来纳州城市地区的平均值进行比较。
该研究得出结论，利用 VUC，来自农村地区面临不平等的患者能够更好地获得医疗保健。通过地理空间分析，提出了建议，以帮助改善农村服务不足人群的医疗保健可及性。
