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美国 COVID-19 大流行期间远程医疗使用和门诊护理的变化。

Variation In Telemedicine Use And Outpatient Care During The COVID-19 Pandemic In The United States.

机构信息

Sadiq Y. Patel is a National Institute of Mental Health postdoctoral research fellow in the Department of Health Care Policy at Harvard Medical School, in Boston, Massachusetts.

Ateev Mehrotra is an associate professor of health care policy and medicine in the Department of Health Care Policy, Harvard Medical School.

出版信息

Health Aff (Millwood). 2021 Feb;40(2):349-358. doi: 10.1377/hlthaff.2020.01786.

Abstract

Coronavirus disease 2019 (COVID-19) spurred a rapid rise in telemedicine, but it is unclear how use has varied by clinical and patient factors during the pandemic. We examined the variation in total outpatient visits and telemedicine use across patient demographics, specialties, and conditions in a database of 16.7 million commercially insured and Medicare Advantage enrollees from January to June 2020. During the pandemic, 30.1 percent of all visits were provided via telemedicine, and the weekly number of visits increased twenty-three-fold compared with the prepandemic period. Telemedicine use was lower in communities with higher rates of poverty (31.9 percent versus 27.9 percent for the lowest and highest quartiles of poverty rate, respectively). Across specialties, the use of any telemedicine during the pandemic ranged from 68 percent of endocrinologists to 9 percent of ophthalmologists. Across common conditions, the percentage of visits provided during the pandemic via telemedicine ranged from 53 percent for depression to 3 percent for glaucoma. Higher rates of telemedicine use for common conditions were associated with smaller decreases in total weekly visits during the pandemic.

摘要

2019 年冠状病毒病(COVID-19)推动了远程医疗的迅速发展,但尚不清楚在大流行期间,远程医疗的使用情况因临床和患者因素而异。我们在 2020 年 1 月至 6 月期间对 1670 万商业保险和医疗保险优势计划参保者的数据库进行了研究,考察了在患者人口统计学、专业和疾病特征方面,总门诊就诊次数和远程医疗使用情况的变化。在大流行期间,30.1%的就诊是通过远程医疗提供的,与大流行前相比,每周就诊次数增加了 23 倍。在贫困率较高的社区,远程医疗的使用频率较低(贫困率最低和最高四分之一的社区分别为 31.9%和 27.9%)。在所有专业中,在大流行期间使用任何远程医疗的医生比例从内分泌科医生的 68%到眼科医生的 9%不等。在常见疾病中,通过远程医疗提供的就诊比例从抑郁症的 53%到青光眼的 3%不等。在大流行期间,常见疾病的远程医疗使用率较高与总就诊次数的降幅较小有关。

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