新冠疫情期间的远程医疗平等获取：小儿耳鼻喉科视角。
Equal Access to Telemedicine during COVID-19 Pandemic: A Pediatric Otolaryngology Perspective.
机构信息
Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, California, U.S.A.
Department of Surgery, Division of Otolaryngology, University of California San Diego, San Diego, California, U.S.A.
出版信息
Laryngoscope. 2021 May;131(5):1175-1179. doi: 10.1002/lary.29164. Epub 2020 Oct 5.
OBJECTIVES/HYPOTHESIS: During the current COVID-19 pandemic, the demand for direct-to-home telemedicine services has risen to an unprecedented level. Equal access to specialty care was assessed to identify potential barriers that may negatively impact telemedicine utilization.
STUDY DESIGN
Retrospective case series.
METHODS
We examined the 6-week period between March and May 2020 when the only access to nonurgent pediatric otolaryngology service was through telemedicine and compared it to in-person visits during the same period in 2019. We compared patient demographics, including age, gender, preferred language, zip code of residence, and primary insurance plan.
RESULTS
A total of 1,495 visits were conducted through telemedicine from March 23, 2020 to May 1, 2020, and 1983 in-person visits were completed in 2019. There was no difference in patient age and gender. The proportions of Spanish-speaking families were similar (15.8% in 2019 vs. 14.4% in 2020, P = .96). The percentage of Medi-Cal-insured patients (51.4% in 2019 vs. 49.8% in 2020, P = .73) and the mean poverty level (12.6% in 2019 vs. 12.2% in 2020, P = .38) also remained the same. Spanish-speaking families were statistically more likely to require rescheduling of their telemedicine visits (17.2%) when compared to the overall rescheduling rate of 11.9% (P = .0083).
CONCLUSIONS
We were able to successfully provide access to telemedicine services to our vulnerable populations during the current COVID-19 pandemic. Telemedicine is likely to remain an essential mode of delivering patient care going forward. It is important to evaluate and identify potential disparities to telemedicine access and proactively implement changes to address these barriers.
LEVEL OF EVIDENCE
- Laryngoscope, 131:1175-1179, 2021.
目的/假设：在当前的 COVID-19 大流行期间，对直接上门的远程医疗服务的需求已上升到前所未有的水平。评估平等获得专科护理的机会，以确定可能对远程医疗利用产生负面影响的潜在障碍。
研究设计
回顾性病例系列。
方法
我们研究了 2020 年 3 月至 5 月期间的 6 周时间，这是获得非紧急儿科耳鼻喉科服务的唯一途径是通过远程医疗，并且将其与同期 2019 年的门诊就诊进行了比较。我们比较了患者的人口统计学特征，包括年龄、性别、首选语言、居住邮政编码和主要保险计划。
结果
2020 年 3 月 23 日至 5 月 1 日期间，通过远程医疗共进行了 1495 次就诊，而 2019 年同期进行了 1983 次门诊就诊。患者的年龄和性别没有差异。讲西班牙语的家庭比例相似（2019 年为 15.8%，2020 年为 14.4%，P=0.96）。Medi-Cal 保险患者的比例（2019 年为 51.4%，2020 年为 49.8%，P=0.73）和平均贫困水平（2019 年为 12.6%，2020 年为 12.2%，P=0.38）也保持不变。与总体重新安排率 11.9%相比，讲西班牙语的家庭统计上更有可能需要重新安排他们的远程医疗就诊（17.2%）（P=0.0083）。
结论
我们能够在当前的 COVID-19 大流行期间成功为我们的弱势群体提供远程医疗服务。远程医疗很可能在未来仍然是提供患者护理的重要模式。评估和确定远程医疗获取的潜在差距，并积极实施变革以解决这些障碍非常重要。
证据水平
- Laryngoscope，131：1175-1179，2021。
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