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Assessment of Disparities in Digital Access Among Medicare Beneficiaries and Implications for Telemedicine.评估医疗保险受益人的数字接入差距及其对远程医疗的影响。
JAMA Intern Med. 2020 Oct 1;180(10):1386-1389. doi: 10.1001/jamainternmed.2020.2666.
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Telemedicine barriers and challenges for persons with disabilities: COVID-19 and beyond.远程医疗对残疾人的障碍和挑战:COVID-19 及其他。
Disabil Health J. 2020 Oct;13(4):100973. doi: 10.1016/j.dhjo.2020.100973. Epub 2020 Jul 9.
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Adjusting to the new reality: Evaluation of early practice pattern adaptations to the COVID-19 pandemic.适应新现实:评估早期实践模式对 COVID-19 大流行的适应。
Gynecol Oncol. 2020 Aug;158(2):256-261. doi: 10.1016/j.ygyno.2020.05.028. Epub 2020 May 23.
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Digital Health Equity as a Necessity in the 21st Century Cures Act Era.数字健康公平是21世纪《治愈法案》时代的一项必要条件。
JAMA. 2020 Jun 16;323(23):2381-2382. doi: 10.1001/jama.2020.7858.
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Beyond broadband: digital inclusion as a driver of inequities in access to rural cancer care.超越宽带:数字包容作为农村癌症护理获取方面不平等的驱动因素。
J Cancer Surviv. 2020 Oct;14(5):643-652. doi: 10.1007/s11764-020-00874-y. Epub 2020 May 11.
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COVID-19 transforms health care through telemedicine: Evidence from the field.COVID-19 通过远程医疗改变医疗保健:来自现场的证据。
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Social Determinants of Potential eHealth Engagement Among People Living with HIV Receiving Ryan White Case Management: Health Equity Implications from Project TECH.社会决定因素对接受 Ryan White 个案管理的 HIV 感染者潜在电子健康参与的影响:来自 Project TECH 的健康公平启示。
AIDS Behav. 2020 May;24(5):1463-1475. doi: 10.1007/s10461-019-02723-1.
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Advancing health equity and access using telemedicine: a geospatial assessment.利用远程医疗推进卫生公平和可及性:一项地理空间评估。
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Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review.门诊远程医疗在老年人中的效果:系统评价。
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Geographic Distribution and Survival Outcomes for Rural Patients With Cancer Treated in Clinical Trials.农村癌症患者临床试验治疗的地理分布和生存结果。
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妇科肿瘤患者在常规护理中已准备好接受远程医疗:COVID-19 大流行前的一项调查结果

Gynecologic oncology patients are ready for telemedicine in routine care: Results from a pre-COVID survey.

作者信息

Dholakia J, Kim J, Liang M I, Arend R C, Bevis K S, Straughn J M, Leath C A, Huh W K, Smith H J

机构信息

Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.

School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.

出版信息

Gynecol Oncol Rep. 2021 Oct 1;38:100871. doi: 10.1016/j.gore.2021.100871. eCollection 2021 Nov.

DOI:10.1016/j.gore.2021.100871
PMID:34646930
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8501666/
Abstract

OBJECTIVES

To assess telemedicine readiness of gynecologic oncology patients, particularly those at risk for care access disparities (increased distance to care, rural populations.).

METHODS

Patients at all disease/treatment stages completed an anonymous survey during in-person outpatient appointments at an academic comprehensive cancer center from 1/6/2020 to 2/28/2020, conducted prior to the COVID-19 pandemic, before the introduction of telemedicine in this practice.

RESULTS

Of 180 patients approached, 170 completed the survey (94.4%). Mean age was 59.6 years; 73.4% identified as White, 23.7% Black, and 2.9% other race. Ovarian cancer was most common (41.2%), followed by endometrial (27.1%), cervical (20.6%), and vaginal/vulvar (7.1%). Most patients traveled > 50 miles for appointments (63.8%); they were more likely from rural counties with significantly higher travel costs/visit ($60.77 vs $37.98, p = 0.026.) The majority expressed interest in using telemedicine (75.7%) or a smartphone app (87.5%) in their care. The majority of patients with difficulty attending appointments (88.9 vs 70.2%, p = 0.02) or from rural counties (88.7% vs 69.6%, p = 0.03) were interested in telemedicine; those with both characteristics reported 100% interest. The majority in both urban and rural counties had home internet access, and reported similarly high rates of daily use (79% vs 75%). Race and age were not associated with differences in internet access or use or telemedicine interest.

CONCLUSIONS

Telemedicine is attractive to the majority of patients and may offer financial/logistical advantages. Patients have high internet use rates and comfort with using technology for healthcare. Telemedicine should be incorporated into standard practice beyond the COVID-19 pandemic to reduce healthcare access disparities.

摘要

目的

评估妇科肿瘤患者对远程医疗的接受程度,尤其是那些面临医疗服务获取差异风险的患者(距离医疗机构较远、农村人口等)。

方法

2020年1月6日至2020年2月28日期间,在一家学术性综合癌症中心进行面对面门诊预约时,处于所有疾病/治疗阶段的患者完成了一项匿名调查,该调查在2019冠状病毒病大流行之前、本医疗机构引入远程医疗之前进行。

结果

在180名被邀请的患者中,170名完成了调查(94.4%)。平均年龄为59.6岁;73.4%为白人,23.7%为黑人,2.9%为其他种族。卵巢癌最为常见(41.2%),其次是子宫内膜癌(27.1%)、宫颈癌(20.6%)和阴道/外阴癌(7.1%)。大多数患者前往预约地点的行程超过50英里(63.8%);他们更有可能来自农村县,每次就诊的交通成本显著更高(60.77美元对37.98美元,p = 0.026)。大多数患者表示有兴趣在其医疗护理中使用远程医疗(75.7%)或智能手机应用程序(87.5%)。大多数难以按时就诊的患者(88.9%对70.2%,p = 0.02)或来自农村县的患者(88.7%对69.6%,p = 0.03)对远程医疗感兴趣;同时具备这两个特征的患者表示100%感兴趣。城市和农村县的大多数人都能在家中使用互联网,且报告的日常使用率相似(79%对75%)。种族和年龄与互联网接入或使用情况以及对远程医疗的兴趣差异无关。

结论

远程医疗对大多数患者具有吸引力,可能提供经济/后勤方面的优势。患者的互联网使用率较高,并且对使用技术进行医疗保健感到舒适。在2019冠状病毒病大流行之后,应将远程医疗纳入标准医疗实践,以减少医疗服务获取方面的差异。