University of California, San Francisco, CA, USA.
Clin Pediatr (Phila). 2022 Jan;61(1):26-33. doi: 10.1177/00099228211045809. Epub 2021 Sep 11.
The COVID-19 (coronavirus disease 2019) pandemic brought rapid expansion of pediatric telehealth to maintain patient access to care while decreasing COVID-19 community spread. We designed a retrospective, serial, cross-sectional study to investigate if telehealth implementation at an academic pediatric practice led to disparities in health care access. Significant differences were found in pre-COVID-19 versus during COVID-19 patient demographics. Patients seen during COVID-19 were more likely to be younger, White/Caucasian or Asian, English speaking, and have private insurance. They were less likely to be Black/African American or Latinx and request interpreters. Age was the only significant difference in patient demographics between in-person and telehealth visits during COVID-19. A multivariate regression showed older age as a significant positive predictor of having a video visit and public insurance as a significant negative predictor. Our study demonstrates telehealth disparities based on insurance existed at our clinic as did inequities in who was seen before versus during COVID-19.
COVID-19（冠状病毒病 2019）大流行促使儿科远程医疗迅速扩张，以维持患者获得医疗服务的机会，同时减少 COVID-19 在社区的传播。我们设计了一项回顾性、连续的、横断面研究，以调查学术儿科实践中远程医疗的实施是否导致医疗保健获取方面的差异。在 COVID-19 之前和期间，患者人口统计学特征存在显著差异。在 COVID-19 期间就诊的患者更年轻，更可能是白人/高加索人或亚洲人，讲英语，并且拥有私人保险。他们不太可能是黑人/非裔美国人或拉丁裔，并要求提供口译员。在 COVID-19 期间，面对面和远程医疗就诊的患者人口统计学特征中，只有年龄存在显著差异。多元回归显示，年龄较大是进行视频访问的显著正预测因素，而公共保险是显著负预测因素。我们的研究表明，我们诊所存在基于保险的远程医疗差异，而且在 COVID-19 之前和期间就诊的患者也存在不公平现象。
