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应对新冠疫情的儿科远程医疗扩展

Pediatric Telehealth Expansion in Response to COVID-19.

作者信息

Williams Stormee, Hill Kristina, Xie Luyu, Mathew M Sunil, Ofori Ashley, Perry Tamara, Wesley Danielle, Messiah Sarah E

机构信息

Children's Health System of Texas, Dallas, TX, United States.

School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, United States.

出版信息

Front Pediatr. 2021 Sep 17;9:642089. doi: 10.3389/fped.2021.642089. eCollection 2021.

Abstract

Telehealth utilization has been steadily increasing for the past two decades and has been recognized for its ability to access rural and underserved populations. The advent of COVID-19 in March 2020 limited the feasibility of in-person healthcare visits which in turn increased telehealth demand and use. However, the long-term impacts of COVID-19 on the telehealth sector of the healthcare industry, and particularly on pediatric healthcare volume demand and subsequent expansion, are yet to be determined. To understand the impact of COVID-19 on telehealth utilization, volume demand, and expansion in one large pediatric healthcare system serving greater Dallas-Fort Worth, Texas, data on telehealth clinic visits by month, pre-COVID and post/current-COVID were compared. A quasi-experimental pretest-posttest design analysis compared telehealth visit counts from 54 ambulatory pediatric health specialties. Pre-post new patient counts were also analyzed via chi square. Total telehealth visit counts significantly increased between March-October 2019 (2,033 visits) compared to March-October 2020 (54,276 visits). Mean monthly telehealth visits increased by 6,530 visits, or 2,569.75% over the same time period ( < 0.0001). In October 2020, total telehealth visits were still 1,194.78% above 2019 levels (345 visits in 2019 vs. 4467 visits in 2020). Results here show a substantial volume increase in telehealth-delivered pediatric healthcare and resource utilization as a response to COVID-19. This provides a template for permanent adoption of pediatric telehealth delivery post pandemic. Further investigation is needed to determine impacts upon resource allocation, processes, and general models and standard of care to assist facilities and programs to better address the needs of the pediatric populations they serve in the post-COVID era.

摘要

在过去二十年中,远程医疗的使用一直在稳步增加,并且因其能够覆盖农村和医疗服务不足的人群而得到认可。2020年3月新冠疫情的出现限制了面对面医疗就诊的可行性,这反过来又增加了对远程医疗的需求和使用。然而,新冠疫情对医疗行业远程医疗领域的长期影响,特别是对儿科医疗服务量需求及后续扩张的影响,仍有待确定。为了解新冠疫情对德克萨斯州达拉斯 - 沃思堡地区一个大型儿科医疗系统中远程医疗使用、服务量需求和扩张的影响,对新冠疫情前和疫情后/当前每月的远程医疗门诊就诊数据进行了比较。采用准实验前后测设计分析,比较了54个门诊儿科健康专科的远程医疗就诊次数。还通过卡方分析对前后新患者数量进行了分析。与2019年3月至10月(2033次就诊)相比,2020年3月至10月的远程医疗就诊总数显著增加(54276次就诊)。同期平均每月远程医疗就诊次数增加了6530次,增幅为2569.75%(<0.0001)。2020年10月,远程医疗就诊总数仍比2019年水平高出1194.78%(2019年为345次就诊,2020年为4467次就诊)。这里的结果表明,作为对新冠疫情的应对措施,通过远程医疗提供的儿科医疗服务和资源利用大幅增加。这为疫情后永久采用儿科远程医疗服务提供了一个模板。需要进一步调查以确定对资源分配、流程以及护理的一般模式和标准的影响,以帮助医疗机构和项目更好地满足其在新冠疫情后时代所服务的儿科人群的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007c/8485024/9f1ce3750aef/fped-09-642089-g0001.jpg

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Pediatric Telehealth Expansion in Response to COVID-19.应对新冠疫情的儿科远程医疗扩展
Front Pediatr. 2021 Sep 17;9:642089. doi: 10.3389/fped.2021.642089. eCollection 2021.

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Telemedicine in Pediatrics: Possibilities and Pitfalls.儿科远程医疗:可能性与陷阱
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The Use of Telehealth in School-Based Health Centers.远程医疗在学校健康中心的应用。
Glob Pediatr Health. 2019 Oct 23;6:2333794X19884194. doi: 10.1177/2333794X19884194. eCollection 2019.
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Patients' Satisfaction with and Preference for Telehealth Visits.患者对远程医疗就诊的满意度及偏好
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