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新冠疫情期间自我报告的远程医疗使用的种族和民族差异:对 3 月下旬美国互联网用户调查的二次分析。

Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March.

机构信息

Department of Sociology, University of Wisconsin, Milwaukee, Wisconsin, USA.

Department of Health Management & Policy, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Am Med Inform Assoc. 2021 Jan 15;28(1):119-125. doi: 10.1093/jamia/ocaa221.

Abstract

OBJECTIVE

Widespread technological changes, like the rapid uptake of telehealth in the US during the COVID-19 pandemic, risk creating or widening racial/ethnic disparities. We conducted a secondary analysis of a cross-sectional, nationally representative survey of internet users to evaluate whether there were racial/ethnic disparities in self-reported telehealth use early in the pandemic.

MATERIALS AND METHODS

The Pew Research Center fielded the survey March 19-24, 2020. Telehealth use because of the pandemic was measured by asking whether respondents (N = 10 624) "used the internet or e-mail to connect with doctors or other medical professionals as a result of the coronavirus outbreak." We conducted survey-weighted logistic regressions, adjusting for respondents' socioeconomic characteristics and perceived threat of the pandemic to their own health (eg, no threat, minor, major).

RESULTS

Approximately 17% of respondents reported using telehealth because of the pandemic, with significantly higher unadjusted odds among Blacks, Latinos, and those identified with other race compared to White respondents. The multivariable logistic regressions and sensitivity analyses show Black respondents were more likely than Whites to report using telehealth because of the pandemic, particularly when perceiving the pandemic as a minor threat to their own health.

DISCUSSION

Black respondents are most likely to report using telehealth because of the COVID-19 pandemic, particularly when they perceive the pandemic as a minor health threat.

CONCLUSION

The systemic racism creating health and health care disparities has likely raised the need for telehealth among Black patients during the pandemic. Findings suggest opportunities to leverage a broadly defined set of telehealth tools to reduce health care disparities postpandemic.

摘要

目的

像新冠疫情期间美国迅速普及远程医疗这样的广泛技术变革,可能会造成或扩大种族/民族差异。我们对一项横断面、全国代表性的互联网用户调查进行了二次分析,以评估在疫情早期,自我报告的远程医疗使用是否存在种族/民族差异。

材料与方法

皮尤研究中心于 2020 年 3 月 19 日至 24 日进行了这项调查。由于疫情而使用远程医疗是通过询问受访者(N=10624)“由于冠状病毒爆发,是否通过互联网或电子邮件与医生或其他医疗专业人员联系”来衡量的。我们进行了调查加权逻辑回归分析,调整了受访者的社会经济特征和对自身健康的疫情威胁感知(例如,无威胁、轻微、严重)。

结果

约有 17%的受访者表示因疫情而使用远程医疗,与白人受访者相比,黑人和拉丁裔以及其他种族的受访者未经调整的优势比显著更高。多变量逻辑回归和敏感性分析表明,黑人受访者比白人受访者更有可能因疫情而报告使用远程医疗,尤其是当他们认为疫情对自己的健康构成轻微威胁时。

讨论

黑人受访者最有可能因 COVID-19 大流行而报告使用远程医疗,尤其是当他们认为大流行对自己的健康构成轻微威胁时。

结论

造成健康和医疗保健差异的系统性种族主义可能在疫情期间增加了黑人患者对远程医疗的需求。研究结果表明,有机会利用广泛定义的一组远程医疗工具来减少大流行后的医疗保健差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2b4/7810440/9e48bdf9aabf/ocaa221f1.jpg

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