Bell Alexander, Lonergan Peter E, Escobar Domenique, Fakunle Mary, Chu Carissa E, Berdy Sara, Palmer Nynikka R, Breyer Benjamin N, Washington Samuel L
School of Medicine, University of California, San Francisco, CA.
Department of Urology, University of California, San Francisco, CA.
Urology. 2022 Apr;162:57-62. doi: 10.1016/j.urology.2021.08.025. Epub 2021 Aug 27.
To analyze the factors associated with non-attendance at a urology telehealth clinic in a large urban safety-net hospital after institutional-mandated transition to telehealth due to COVID-19.
We identified all encounters scheduled for telehealth after March 17, 2020 and in the subsequent 8 weeks. Logistic regression was used to identify factors associated with attendance.
In total there were 322 telehealth encounters, 228 (70.8%) of which were attended and 94 (29.2%) that were not attended. Racial/ethnic minorities accounted for 175 (77.0%) of attended and 73 (76.7%) of non-attended encounters. On multivariable regression, single/divorced/widowed (odds ratio [OR] 2.36, 95% confidence interval [CI] 1.26-4.43), current substance use disorder (OR 5.33, 95% CI 2.04-13.98), and being scheduled for a new patient appointment (OR 1.81, 95% CI 1.04-3.13) were associated with higher odds of not attending a telehealth encounter. Race/ethnicity, primary language, and country of birth were not associated with odds of attendance.
Our findings identify several social factors (social support, substance use) associated with non-attendance at outpatient telehealth urology encounters at an urban safety-net hospital during the early stages of the COVID-19 pandemic. These barriers may have a greater impact specifically within a safety-net healthcare system and will inform equitable provision of urology telehealth programs in the future FUNDING: Goldberg-Benioff Endowed Professorship in Cancer Biology. The sponsors had no involvement with this study.
分析在一家大型城市安全网医院因新冠疫情机构强制转为远程医疗后，与泌尿外科远程医疗门诊未就诊相关的因素。
我们确定了2020年3月17日之后及随后8周内安排的所有远程医疗会诊。采用逻辑回归来确定与就诊相关的因素。
总共有322次远程医疗会诊，其中228次（70.8%）就诊，94次（29.2%）未就诊。少数族裔占就诊会诊的175次（77.0%）和未就诊会诊的73次（76.7%）。在多变量回归中，单身/离婚/丧偶（比值比[OR]2.36，95%置信区间[CI]1.26 - 4.43）、当前物质使用障碍（OR 5.33，95% CI 2.04 - 13.98）以及安排为新患者预约（OR 1.81，95% CI 1.04 - 3.13）与远程医疗会诊未就诊的较高几率相关。种族/民族、主要语言和出生国家与就诊几率无关。
我们的研究结果确定了几个与新冠疫情早期城市安全网医院门诊泌尿外科远程医疗会诊未就诊相关的社会因素（社会支持、物质使用）。这些障碍可能在安全网医疗系统中产生更大影响，并将为未来泌尿外科远程医疗项目的公平提供提供参考。资金来源：癌症生物学戈德堡 - 贝尼奥夫捐赠教授职位。资助者未参与本研究。
