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新冠疫情期间远程医疗利用的差异:来自美国全国代表性调查的结果。

Disparities in telehealth utilization during the COVID-19 pandemic: Findings from a nationally representative survey in the United States.

机构信息

Department of Health Policy and Management, College of Public Health, University of Georgia, USA.

Department of Public Health Sciences, Clemson University, USA.

出版信息

J Telemed Telecare. 2024 Jan;30(1):90-97. doi: 10.1177/1357633X211051677. Epub 2021 Oct 11.

Abstract

Telehealth is an important source of health care during the COVID-19 pandemic. Evidence is scarce regarding disparities in telehealth utilization in the United States. We aimed to investigate the prevalence and factors associated with telehealth utilization among US adults. Our data came from the Health, Ethnicity, and Pandemic Study, a nationally representative survey conducted in October 2020, with 2554 adults ≥ 18 and an oversample of racial/ethnic minorities. Telehealth utilization was measured as self-reported teleconsultation with providers via email, text message, phone, video, and remote patient monitoring during the pandemic. Logistic regressions were performed to examine the association between telehealth use and factors at the individual, household, and community levels. Overall, 43% of the sample reported having used telehealth, representing 114.5 million adults in the nation. East and Southeast Asians used telehealth less than non-Hispanic Whites (OR = 0.5, 95% CI: 0.3-0.8). Being uninsured (compared with private insurance: OR = 0.4, 95% CI: 0.2-0.8), and those with limited broadband coverage in the community (OR = 0.5, 95% CI: 0.3-0.8) were less likely to use telehealth. There is a need to develop and implement more equitable policies and interventions at both the individual and community levels to improve access to telehealth services and reduce related disparities.

摘要

远程医疗是 COVID-19 大流行期间重要的医疗保健来源。关于美国远程医疗利用方面的差异,证据很少。我们旨在研究美国成年人中远程医疗利用的流行率和相关因素。我们的数据来自健康、种族和大流行研究,这是一项于 2020 年 10 月进行的全国代表性调查,共有 2554 名年龄在 18 岁及以上的成年人和一个代表性更大的少数族裔样本。远程医疗利用情况通过自我报告在大流行期间通过电子邮件、短信、电话、视频和远程患者监测与提供者进行的远程咨询来衡量。进行了逻辑回归分析,以检查个体、家庭和社区层面的因素与远程医疗使用之间的关联。总体而言,该样本中有 43%的人报告使用过远程医疗,这代表全国有 1.145 亿成年人使用过远程医疗。东亚和东南亚人使用远程医疗的比例低于非西班牙裔白人(OR=0.5,95%CI:0.3-0.8)。未参保(与私人保险相比:OR=0.4,95%CI:0.2-0.8),以及社区宽带覆盖率有限的人(OR=0.5,95%CI:0.3-0.8)不太可能使用远程医疗。需要在个人和社区层面制定和实施更加公平的政策和干预措施,以改善远程医疗服务的可及性并减少相关差异。

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