Huang Jie, Graetz Ilana, Millman Andrea, Gopalan Anjali, Lee Catherine, Muelly Emilie, Reed Mary E
Kaiser Permanente Division of Research, Oakland, California, USA.
Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
JAMIA Open. 2022 Jan 19;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002. eCollection 2022 Apr.
The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. We used multivariate logistic regression to examine the association between the choice of video versus telephone and patient sociodemographic characteristics and technology access among patient-initiated primary care telemedicine visits scheduled online from March to October 2020. Among 978 272 patient-scheduled primary care telemedicine visits, 39% were video visits. Patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggest the persistence of a digital divide, emphasizing the importance of maintaining a telephone telemedicine option.
本研究的目的是探讨在新冠疫情期间,综合医疗服务系统中自行安排就诊的患者的特征与初级保健远程医疗选择之间的关联。我们使用多变量逻辑回归分析,研究了2020年3月至10月期间患者发起的在线预约初级保健远程医疗就诊中,视频就诊与电话就诊选择与患者社会人口学特征及技术接入之间的关联。在978272次患者预约的初级保健远程医疗就诊中,39%为视频就诊。黑人或西班牙裔种族/族裔的患者,或生活在社会经济地位较低或互联网接入率较低社区的患者,安排视频就诊的可能性较小。65岁及以上的患者、有过视频就诊经历或可使用移动门户的患者,或就诊于自己的私人医生的患者,安排视频就诊的可能性较大。虽然在所研究的所有患者群体中视频就诊的采用率都很高,但远程医疗选择上的差异表明数字鸿沟依然存在,这凸显了保留电话远程医疗选项的重要性。