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美国医院在 COVID-19 大流行期间的远程医疗可用性。

Telehealth Availability in US Hospitals in the Face of the COVID-19 Pandemic.

机构信息

Department of Management Programs, Florida Atlantic University, Boca Raton, Florida.

出版信息

J Rural Health. 2020 Sep;36(4):577-583. doi: 10.1111/jrh.12482. Epub 2020 Jun 30.

Abstract

BACKGROUND

Telehealth is likely to play a crucial role in treating COVID-19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals' readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas.

METHODS

Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals.

RESULTS

We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10).

CONCLUSIONS

US hospitals vary in their preparation to use telehealth to aid in the COVID-19 battle, among other issues. Hospitals' odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID-19.

摘要

背景

远程医疗在治疗 COVID-19 患者方面可能发挥关键作用。然而,并非所有美国医院都具备远程医疗能力。本简要报告旨在探讨美国医院在远程医疗可用性方面的准备情况。我们希望更深入地了解影响这些宝贵能力的因素,以及这些因素在农村和城市地区之间的差异。

方法

基于美国医院协会调查、地区卫生资源档案和医疗保险成本报告 2017 年的数据,我们使用逻辑回归模型来确定美国医院拥有远程医疗和 eICU 能力的预测因素。

结果

我们发现较大的医院(OR(远程医疗)= 1.013;P <.01)和系统成员(OR(远程医疗)= 1.55;P <.01)(OR(eICU)= 1.65;P <.01)拥有远程医疗和 eICU 能力的可能性更高。我们还发现有证据表明,远程医疗和 eICU 能力集中在特定地区;鉴于这些医院拥有远程医疗(OR = 1.49;P <.10)和 eICU 能力(OR = 2.15;P <.05)的可能性更高,中西北部地区最有可能拥有这些能力。与城市同行相比,农村医院拥有远程医疗能力的可能性更高,尽管这种关系略微显著(OR = 1.34,P <.10)。

结论

美国医院在准备利用远程医疗援助 COVID-19 等问题方面存在差异。医院拥有提供此类服务能力的可能性在很大程度上因地区而异;总体而言,农村医院的远程医疗能力比城市医院更为广泛。进一步扩大这些能力仍有很大潜力,尤其是在 COVID-19 疫情严重的地区。

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本文引用的文献

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Telehealth: A Balanced Look at Incorporating This Technology Into Practice.远程医疗:全面审视将这项技术应用于实践的情况。
SAGE Open Nurs. 2018 Jul 23;4:2377960818786504. doi: 10.1177/2377960818786504. eCollection 2018 Jan-Dec.
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Does telemonitoring of patients--the eICU--improve intensive care?患者远程监护(eICU)是否能改善重症监护?
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