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在2017年大西洋飓风季期间,美国退伍军人事务部利用远程医疗改善医疗服务可及性。

Use of Telehealth to Improve Access to Care at the United States Department of Veterans Affairs During the 2017 Atlantic Hurricane Season.

作者信息

Der-Martirosian Claudia, Chu Karen, Dobalian Aram

机构信息

Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California.

Division of Health Systems Management and Policy, University of Memphis School of Public Health, Memphis, Tennessee.

出版信息

Disaster Med Public Health Prep. 2020 Apr 13;17:e6. doi: 10.1017/dmp.2020.88.

Abstract

OBJECTIVES

This brief report examines the shift from in-person care to US Department of Veterans Affairs (VA) telehealth services during 3 devastating hurricanes in 2017 (Harvey, Irma, and Maria).

METHODS

VA administrative data were used to analyze the number and percentage of telehealth services 30 d pre- and 30 d post- the 2017 hurricanes for 3 hurricane-impacted VA medical centers (VAMCs): Houston (Texas), Orlando (Florida), and San Juan (Puerto Rico).

RESULTS

All 3 VAMCs remained open during the hurricanes. For the Houston VAMC, during the first week post-Harvey, in-person patient visits decreased while telehealth visits increased substantially. Similarly, for the Orlando VAMC, during the 1-wk post-Irma, telehealth use increased substantially. For the San Juan VAMC, there were many interruptions in the use of telehealth due to many power outages, resulting in a modest increase in the use of telehealth post-Irma/Maria. The most commonly used telehealth services at Houston and Orlando VAMCs during the hurricanes were: primary care, triage, mental health, and home health.

CONCLUSIONS

Telehealth has the potential to improve post-disaster access to and coordination of care. However, more information is needed to better understand how telehealth services can be used as a post-disaster health-care delivery tool, particularly for patients receiving care outside of systems such as VA.

摘要

目的

本简要报告考察了在2017年三场毁灭性飓风(哈维、厄玛和玛丽亚)期间,美国退伍军人事务部(VA)从面对面医疗服务向远程医疗服务的转变。

方法

利用VA行政数据,分析了2017年飓风来袭前30天和来袭后30天,3家受飓风影响的VA医疗中心(VAMC):休斯顿(得克萨斯州)、奥兰多(佛罗里达州)和圣胡安(波多黎各)的远程医疗服务数量及百分比。

结果

所有3家VAMC在飓风期间均保持开放。对于休斯顿VAMC,在哈维飓风过后的第一周,面对面患者就诊量减少,而远程医疗就诊量大幅增加。同样,对于奥兰多VAMC,在厄玛飓风过后的1周内,远程医疗的使用大幅增加。对于圣胡安VAMC,由于多次停电,远程医疗的使用出现诸多中断,导致在厄玛/玛丽亚飓风过后远程医疗的使用略有增加。飓风期间,休斯顿和奥兰多VAMC最常用的远程医疗服务包括:初级保健、分诊、心理健康和家庭保健。

结论

远程医疗有潜力改善灾后医疗服务的可及性和协调性。然而,需要更多信息来更好地理解如何将远程医疗服务用作灾后医疗服务提供工具,特别是对于在VA等系统之外接受治疗的患者。

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