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新冠疫情期间医疗中心的远程医疗实践 - 美国,2020 年 7 月 11 日至 17 日。

Telehealth Practice Among Health Centers During the COVID-19 Pandemic - United States, July 11-17, 2020.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Dec 18;69(50):1902-1905. doi: 10.15585/mmwr.mm6950a4.

Abstract

Early in the coronavirus disease 2019 (COVID-19) pandemic, in-person ambulatory health care visits declined by 60% across the United States, while telehealth* visits increased, accounting for up to 30% of total care provided in some locations (1,2). In March 2020, the Centers for Medicare & Medicaid Services (CMS) released updated regulations and guidance changing telehealth provisions during the COVID-19 Public Health Emergency, including the elimination of geographic barriers and enhanced reimbursement for telehealth services (3-6). The Health Resources and Services Administration (HRSA) administers a voluntary weekly Health Center COVID-19 Survey to track health centers' COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and staff. CDC and HRSA analyzed data from the weekly COVID-19 survey completed by 1,009 HRSA-funded health centers (health centers) for the week of July 11-17, 2020, to describe telehealth service use in the United States by U.S. Census region,** urbanicity, staffing capacity, change in visit volume, and personal protective equipment (PPE) supply. Among the 1,009 health center respondents, 963 (95.4%) reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of health care visits virtually (i.e., via telehealth) than were health centers in rural areas. Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS's change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources.

摘要

在 2019 冠状病毒病(COVID-19)大流行早期,全美门诊就诊量下降了 60%,而远程医疗*就诊量增加,在某些地方占总就诊量的 30%(1,2)。2020 年 3 月,医疗保险和医疗补助服务中心(CMS)发布了更新的规定和指导意见,改变了 COVID-19 公共卫生紧急情况下的远程医疗规定,包括取消地理障碍和增加远程医疗服务的报销(3-6)。卫生资源和服务管理局(HRSA)管理一项每周一次的卫生中心 COVID-19 调查,以跟踪卫生中心的 COVID-19 检测能力以及 COVID-19 对运营、患者和工作人员的影响。疾病预防控制中心和卫生资源与服务管理局分析了 2020 年 7 月 11 日至 17 日期间,1009 个由 HRSA 资助的卫生中心(卫生中心)完成的每周 COVID-19 调查数据,以描述美国按美国人口普查区域、**城市人口密度、人员配备能力、就诊量变化和个人防护设备(PPE)供应情况的远程医疗服务使用情况。在 1009 个卫生中心受访者中,963 个(95.4%)报告提供远程医疗服务。城市地区的卫生中心比农村地区的卫生中心更有可能通过远程医疗(即通过远程医疗)提供超过 30%的医疗服务。远程医疗是促进获得医疗服务的一种很有前途的方法,可以促进公共卫生缓解策略并有助于防止 SARS-CoV-2 和其他呼吸道疾病的传播,同时支持医疗服务的连续性。尽管 CMS 改变了其远程医疗规定,通过调整指导意见和利用联邦资源使卫生中心能够扩大远程医疗服务,但维持远程医疗服务的扩大使用可能需要额外的政策和资源。

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