Barbosa William, Zhou Kina, Waddell Emma, Myers Taylor, Dorsey E Ray
Department of Neurology, University of Rochester Medical Center, Rochester, New York 14642, USA; email:
School of Medicine and Dentistry, University of Rochester, Rochester, New York 14642, USA.
Annu Rev Public Health. 2021 Apr 1;42:463-481. doi: 10.1146/annurev-publhealth-090519-093711.
Over the past 20 years, the use of telemedicine has increased exponentially. Its fundamental aim is to improve access to care. In this review, we assess the extent to which telemedicine has fulfilled this promise across medical domains. Additionally, we assess whether telemedicine has improved related health outcomes. Finally, we determine who has benefited from this novel form of health care delivery. A review of the literature indicates that () telemedicine has improved access to care for a wide range of clinical conditions ranging from stroke to pregnancy; () telemedicine in select circumstances has demonstrated improved health outcomes; and () telemedicine has addressed geographical, but less so social, barriers to care. For telemedicine to fulfill its promise, additional evidence needs to be gathered on health outcomes and cost savings, the digital divide needs to be bridged, and policy changes that support telemedicine reimbursement need to be enacted.
在过去20年里，远程医疗的使用呈指数级增长。其根本目标是改善医疗服务的可及性。在本综述中，我们评估了远程医疗在各个医学领域实现这一承诺的程度。此外，我们评估了远程医疗是否改善了相关的健康结果。最后，我们确定谁从这种新型医疗服务提供形式中受益。文献综述表明：（1）远程医疗改善了从中风到妊娠等广泛临床病症的医疗服务可及性；（2）在特定情况下，远程医疗已证明能改善健康结果；（3）远程医疗克服了地理上的医疗障碍，但在克服社会医疗障碍方面做得较少。为使远程医疗实现其承诺，需要收集更多关于健康结果和成本节约的证据，弥合数字鸿沟，并制定支持远程医疗报销的政策变革。
