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新冠疫情第一年采用远程医疗的促进因素和障碍:系统评价。

Facilitators and Barriers to the Adoption of Telemedicine During the First Year of COVID-19: Systematic Review.

机构信息

School of Health Administration, Texas State University, San Marcos, TX, United States.

出版信息

J Med Internet Res. 2022 Jan 4;24(1):e31752. doi: 10.2196/31752.


DOI:10.2196/31752
PMID:34854815
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8729874/
Abstract

BACKGROUND: The virulent and unpredictable nature of COVID-19 combined with a change in reimbursement mechanisms both forced and enabled the rapid adoption of telemedicine around the world. Thus, it is important to now assess the effects of this rapid adoption and to determine whether the barriers to such adoption are the same today as they were under prepandemic conditions. OBJECTIVE: The objective of this systematic literature review was to examine the research literature published during the COVID-19 pandemic to identify facilitators, barriers, and associated medical outcomes as a result of adopting telemedicine, and to determine if changes have occurred in the industry during this time. METHODS: The systematic review was performed in accordance with the Kruse protocol and the results are reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We analyzed 46 research articles from five continents published during the first year of the COVID-19 pandemic that were retrieved from searches in four research databases: PubMed (MEDLINE), CINAHL, Science Direct, and Web of Science. RESULTS: Reviewers identified 25 facilitator themes and observations, 12 barrier themes and observations, and 14 results (compared to a control group) themes and observations. Overall, 22% of the articles analyzed reported strong satisfaction or satisfaction (zero reported a decline in satisfaction), 27% reported an improvement in administrative or efficiency results (as compared with a control group), 14% reported no statistically significant difference from the control group, and 40% and 10% reported an improvement or no statistically significant difference in medical outcomes using the telemedicine modality over the control group, respectively. CONCLUSIONS: The pandemic encouraged rapid adoption of telemedicine, which also encouraged practices to adopt the modality regardless of the challenges identified in previous research. Several barriers remain for health policymakers to address; however, health care administrators can feel confident in the modality as the evidence largely shows that it is safe, effective, and widely accepted.

摘要

背景:COVID-19 的高传染性和不可预测性,加上报销机制的改变,迫使并促使全球迅速采用远程医疗。因此,现在评估这种快速采用的效果并确定在大流行期间采用远程医疗的障碍是否与大流行前的障碍相同是很重要的。

目的:本系统文献综述的目的是检查在 COVID-19 大流行期间发表的研究文献,以确定采用远程医疗的促进因素、障碍和相关医疗结果,并确定在此期间该行业是否发生了变化。

方法:系统评价按照 Kruse 方案进行,结果按照 PRISMA(系统评价和荟萃分析的首选报告项目)指南报告。我们分析了 COVID-19 大流行第一年从四个研究数据库(PubMed(MEDLINE)、CINAHL、Science Direct 和 Web of Science)检索到的来自五大洲的 46 篇研究文章。

结果:审稿人确定了 25 个促进因素主题和观察结果、12 个障碍主题和观察结果以及 14 个结果(与对照组相比)主题和观察结果。总体而言,22%的分析文章报告了强烈的满意度或满意度(零报告满意度下降),27%报告了行政或效率结果的改善(与对照组相比),14%报告与对照组无统计学显著差异,40%和 10%分别报告了使用远程医疗模式与对照组相比,医疗结果得到改善或无统计学显著差异。

结论:大流行促使远程医疗迅速采用,这也促使实践采用该模式,而不管之前研究中确定的挑战如何。卫生政策制定者仍有一些障碍需要解决;然而,医疗保健管理人员可以对该模式充满信心,因为大量证据表明该模式是安全、有效和广泛接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/121f/8729874/d9a54a905304/jmir_v24i1e31752_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/121f/8729874/d9a54a905304/jmir_v24i1e31752_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/121f/8729874/d9a54a905304/jmir_v24i1e31752_fig1.jpg

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[8]
Willingness of healthcare professionals in China to continue participating in and recommend telemedicine post COVID-19 pandemic.

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[9]
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[10]
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本文引用的文献

[1]
Tele-Urology During COVID-19: Rapid Implementation of Remote Video Visits.

Urol Pract. 2020-11

[2]
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Cardiovasc Digit Health J. 2020-12-25

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J Am Acad Orthop Surg Glob Res Rev. 2020-9

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BMJ. 2021-3-29

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Gynecol Oncol Rep. 2021-5

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PM R. 2021-12

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Impact of COVID-19 on the psychological health of university students in Spain and their attitudes toward Mobile mental health solutions.

Int J Med Inform. 2021-3

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