Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada.
J Comp Eff Res. 2021 Feb;10(2):119-126. doi: 10.2217/cer-2020-0187. Epub 2021 Jan 15.
To assess the patient-related barriers to access of some virtual healthcare tools among cancer patients in the USA in a population-based cohort. National Health Interview Survey datasets (2011-2018) were reviewed and adult participants (≥18 years old) with a history of cancer diagnosis and complete information about virtual healthcare utilization (defined by [a] filling a prescription on the internet in the past 12 months and/or [b] communicating with a healthcare provider through email in the past 12 months) were included. Information about video-conferenced phone calls and telephone calls are not available in the National Health Interview Survey datasets; and thus, they were not examined in this study. Multivariable logistic regression analysis was used to evaluate factors associated with the utilization of virtual care tools. A total of 25,121 participants were included in the current analysis; including 4499 participants (17.9%) who utilized virtual care in the past 12 months and 20,622 participants (82.1%) who did not utilize virtual care in the past 12 months. The following factors were associated with less utilization of virtual healthcare tools in multivariable logistic regression: older age (continuous odds ratio [OR] with increasing age: 0.987; 95% CI: 0.984-0.990), African-American race (OR for African American vs white race: 0.608; 95% CI: 0.517-0.715), unmarried status (OR for unmarried compared with married status: 0.689; 95% CI: 0.642-0.739), lower level of education (OR for education ≤high school vs >high school: 0.284; 95% CI: 0.259-0.311), weaker English proficiency (OR for no proficiency vs very good proficiency: 0.224; 95% CI: 0.091-0.552) and lower yearly earnings (OR for earnings <$45,000 vs earnings >$45,000: 0.582; 95% CI: 0.523-0.647). Older patients, those with African-American race, lower education, lower earnings and weak English proficiency are less likely to access the above studied virtual healthcare tools. Further efforts are needed to tackle disparities in telemedicine access.
评估美国癌症患者在基于人群的队列中使用某些虚拟医疗保健工具的患者相关障碍。审查了国家健康访谈调查数据集（2011-2018 年），并纳入了有癌症病史且完整信息的成年参与者（≥18 岁），包括在过去 12 个月内通过互联网开处方（定义为[a]）和/或在过去 12 个月内通过电子邮件与医疗保健提供者进行沟通[b]）。国家健康访谈调查数据集不提供视频电话和电话信息；因此，本研究未对此进行检查。多变量逻辑回归分析用于评估与虚拟护理工具使用相关的因素。当前分析共纳入 25121 名参与者，其中包括 4499 名（17.9%）在过去 12 个月内使用过虚拟护理工具，20622 名（82.1%）在过去 12 个月内未使用过虚拟护理工具。多变量逻辑回归分析显示，以下因素与较少使用虚拟医疗保健工具相关：年龄较大（连续年龄比[OR]：0.987；95%CI：0.984-0.990）、非裔美国人种族（非裔美国人与白人种族的 OR：0.608；95%CI：0.517-0.715）、未婚（与已婚相比的 OR：0.689；95%CI：0.642-0.739）、受教育程度较低（与高中以上学历相比的 OR：0.284；95%CI：0.259-0.311）、英语水平较低（无熟练程度与非常熟练程度的 OR：0.224；95%CI：0.091-0.552）和较低的年收入（收入<$45,000 与收入>$45,000 的 OR：0.582；95%CI：0.523-0.647）。年龄较大的患者、非裔美国人、受教育程度较低、收入较低和英语水平较弱的患者不太可能使用上述研究中的虚拟医疗保健工具。需要进一步努力解决远程医疗获取方面的差异。
