Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, CA, USA.
University of California, San Diego San Diego, CA, USA.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720931715. doi: 10.1177/2150132720931715.
Research on patient characteristics of telehealth users is relatively new. More studies are needed to understand the characteristics of telehealth users during disasters. This study attempts to bridge this gap and examines patient characteristics of telehealth users compared with nontelehealth users at the Houston VA Medical Center (VAMC) immediately before and after Hurricane Harvey (2017). Since use of telehealth services reached its peak and gradually declined within 2 weeks after the landfall, the data analyses focused on 14 days before/14 days after Harvey. Two sets of analyses were conducted using chi-square, test, and one-way analysis of variance: (1) Patient characteristics of telehealth users were compared with nontelehealth users. (2) Patient characteristics were compared between 3 subgroups of telehealth users. Compared with nontelehealth users, telehealth users were older (mean age: 60.8 vs 58.5 years, < .001) and had a higher mean Nosos health risk score (1.9 vs 1.4, < .001). They also had a higher mean number of outpatient visits (28.0 vs 19.8, < .001), higher emergency room use (37% vs 29%, < .001), and higher rates of hospitalizations (21% vs 13%, < .001) during the 12 months before Harvey. When compared to less frequent telehealth users, the most frequent telehealth users were the oldest and most medically complex patients. As the largest integrated health care system in the United States, the VA has many advantages favoring successful implementation of telehealth services during disasters. However, more research is needed to better understand how VA telehealth could meet the varying needs of veterans to lower risk of harm during differing types of disasters.
远程医疗用户的患者特征研究相对较新。需要更多的研究来了解灾难期间远程医疗用户的特征。本研究试图弥补这一空白，比较了 2017 年哈维飓风前后休斯顿退伍军人事务医疗中心（VA 医疗中心）的远程医疗用户和非远程医疗用户的患者特征。由于远程医疗服务的使用在飓风登陆后两周内达到峰值并逐渐下降，因此数据分析集中在哈维前后的 14 天。使用卡方检验、t 检验和单因素方差分析进行了两组分析：（1）比较远程医疗用户与非远程医疗用户的患者特征。（2）比较 3 组远程医疗用户的患者特征。与非远程医疗用户相比，远程医疗用户年龄较大（平均年龄：60.8 岁比 58.5 岁，<.001），Nosos 健康风险评分较高（1.9 比 1.4，<.001）。他们在哈维飓风前 12 个月的门诊就诊次数也较多（28.0 次比 19.8 次，<.001），急诊室就诊率较高（37%比 29%，<.001），住院率较高（21%比 13%，<.001）。与较少使用远程医疗的用户相比，最频繁使用远程医疗的用户年龄最大，医疗需求最复杂。作为美国最大的综合医疗保健系统，VA 有许多优势有利于在灾难期间成功实施远程医疗服务。然而，需要进一步的研究来更好地了解 VA 远程医疗如何满足退伍军人在不同类型的灾难中降低伤害风险的不同需求。
