William F Connell School of Nursing, Boston College, Chestnut Hill, MA, United States.
Health Union, LLC, Philadelphia, PA, United States.
J Med Internet Res. 2021 Feb 18;23(2):e23795. doi: 10.2196/23795.
It has been widely communicated that individuals with underlying health conditions are at higher risk of severe disease due to COVID-19 than healthy peers. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. To date, however, little information has been provided regarding telehealth uptake among this high-risk population.
The aim of this study is to describe the telehealth use, resource needs, and information sources of individuals with chronic conditions during the COVID-19 pandemic. Secondary objectives include exploring differences in telehealth use by sociodemographic characteristics.
Data for this study were collected through an electronic survey distributed between May 12-14, 2020, to members of 26 online health communities for individuals with chronic disease. Descriptive statistics were run to explore telehealth use, support needs, and information sources, and z tests were run to assess differences in sociodemographic factors and information and support needs among those who did and did not use telehealth services.
Among the 2210 respondents, 1073 (49%) reported engaging in telehealth in the past 4 months. Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003). Although 59% (133/244) of those younger than 40 years and 54% (263/486) of those aged 40-55 years used telehealth, aging populations were less likely to do so, with only 45% (677/1500) of individuals 56 years or older reporting telehealth use (P<.001 and P=.001, respectively). Patients with cystic fibrosis, lupus, and ankylosing spondylitis recorded the highest proportions of individuals using telehealth when compared to those with other diagnoses. Of the 2210 participants, 1333 (60%) participants either looked up information about the virus online or planned to in the future, and when asked what information or support would be most helpful right now, over half (1151/2210, 52%) responded "understanding how COVID-19 affects people with my health condition."
Nearly half of the study sample reported participating in telehealth in the past 4 months. Future efforts to engage individuals with underlying medical conditions in telehealth should focus on outreach to men, members of lower-income households, and aging populations. These results may help inform and refine future health communications to further engage this at-risk population in telehealth as the pandemic continues.
人们广泛认为,与健康同龄人相比,患有基础疾病的个体因 COVID-19 而患重病的风险更高。随着 COVID-19 大流行期间继续采取社会疏离措施,专家鼓励有基础疾病的人进行远程医疗预约,以在尽量降低风险暴露的同时保持护理的连续性。然而,迄今为止,有关这一高危人群使用远程医疗的信息很少。
本研究的目的是描述 COVID-19 大流行期间慢性病患者的远程医疗使用、资源需求和信息来源。次要目标包括探索按社会人口统计学特征划分的远程医疗使用差异。
本研究的数据通过电子调查收集,该调查于 2020 年 5 月 12 日至 14 日分发给 26 个在线慢性病患者健康社区的成员。运行描述性统计数据以探索远程医疗使用、支持需求和信息来源,并运行 z 检验以评估在使用和未使用远程医疗服务的人群中,社会人口统计学因素和信息及支持需求方面的差异。
在 2210 名受访者中,有 1073 人(49%)报告在过去 4 个月内进行了远程医疗。女性参与远程医疗的比例高于男性(890/1781,50%比 181/424,43%;P=.007),家庭收入超过 10 万美元的人参与远程医疗的比例高于收入低于 3 万美元的人(195/370,53%比 241/530,45%;P=.003)。尽管 59%(133/244)的 40 岁以下人群和 54%(263/486)的 40-55 岁人群使用了远程医疗,但年龄较大的人群使用远程医疗的可能性较小,只有 56 岁及以上的人群中 45%(677/1500)报告使用了远程医疗(P<.001 和 P=.001)。与其他诊断相比,囊性纤维化、狼疮和强直性脊柱炎患者的远程医疗使用率最高。在 2210 名参与者中,有 1333 名(60%)参与者要么在网上查找过有关病毒的信息,要么计划在未来查找,当被问及现在最需要哪些信息或支持时,超过一半(1151/2210,52%)的人回答“了解 COVID-19 如何影响我这种健康状况的人”。
近一半的研究样本报告在过去 4 个月内参与了远程医疗。未来让有基础医疗条件的人参与远程医疗的努力应侧重于向男性、低收入家庭和老年人群体进行宣传。这些结果可能有助于为进一步吸引这一高危人群参与远程医疗提供信息和完善未来的健康传播,因为大流行仍在继续。