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新冠疫情前后美国退伍军人事务部远程医疗和面对面脊椎按摩治疗的使用变化。

Changes in the Use of Telehealth and Face-To-Face Chiropractic Care in the Department of Veterans Affairs Before and After the COVID-19 Pandemic.

机构信息

Yale Center for Medical Informatics, Yale University, New Haven, and VA Connecticut Healthcare System, Connecticut.

Yale Center for Medical Informatics, Yale University, New Haven, and VA Connecticut Healthcare System, Connecticut.

出版信息

J Manipulative Physiol Ther. 2021 Sep;44(7):584-590. doi: 10.1016/j.jmpt.2021.12.002. Epub 2021 Dec 18.

Abstract

OBJECTIVE

The purpose of this study was to describe the use of face-to-face and telehealth chiropractic care in the U.S. Veterans Health Administration (VHA) before and after the declaration of the COVID-19 pandemic.

METHODS

A cross-sectional study was performed of VHA administrative data, including monthly numbers of unique patients and visits for face-to-face and telehealth (synchronous video or telephone) chiropractic care from October 1, 2019, to March 31, 2021.

RESULTS

During the pre-pandemic phase (October 2019 to February 2020), a mean of 28 930 (SD 289) total monthly visits were conducted face-to-face (99.9%). In March 2020, total monthly visits decreased to 17.0% of the pre-pandemic average, 25.0% being face-to-face, with over a 200-fold increase in telehealth visits (rising to 1331 visits) compared to the pre-pandemic average. April showed the lowest number of face-to-face visits at (4094). May-October 2020 showed that face-to-face visits increase on average by 70.7% per month, while telehealth visits averaged 17.3% per month. October-February 2020 had total monthly visits plateau at a mean of 22 250 (76.9% of the pre-pandemic average). Telehealth visits reduced to a mean of 1245 monthly visits over this 5-month period, a drop of -5.6% of the average of monthly visits. In March 2021, total monthly visits (31 221) exceeded the pre-pandemic average for the first time since January 2020; 4.0% remained in telehealth.

CONCLUSION

Face-to-face visits decreased early in the pandemic but increased after May 2020. Chiropractic telehealth use rapidly increased during the early stage of the COVID-19 pandemic, and decreased later, but remained slightly higher than pre-pandemic levels.

摘要

目的

本研究旨在描述 COVID-19 大流行前后美国退伍军人事务部(VHA)面对面和远程医疗(同步视频或电话)的脊医护理的使用情况。

方法

对 VHA 管理数据进行了横断面研究,包括 2019 年 10 月 1 日至 2021 年 3 月 31 日期间每月面对面(99.9%)和远程医疗(同步视频或电话)脊医护理的独特患者和就诊次数。

结果

在大流行前阶段(2019 年 10 月至 2020 年 2 月),每月总就诊次数平均为 28930(SD 289),其中 100%为面对面就诊。2020 年 3 月,每月总就诊次数降至大流行前平均水平的 17.0%,其中 25.0%为面对面就诊,与大流行前平均水平相比,远程医疗就诊次数增加了 200 多倍(上升至 1331 次)。4 月显示面对面就诊次数最低(4094 次)。2020 年 5 月至 10 月,每月面对面就诊次数平均增加 70.7%,而远程医疗就诊次数平均每月增加 17.3%。2020 年 10 月至 2 月,每月总就诊次数平均保持在 22250 次(大流行前平均水平的 76.9%)。在此 5 个月期间,远程医疗就诊次数减少至平均每月 1245 次,降幅为每月就诊次数的 5.6%。2021 年 3 月,总就诊次数(31221 次)首次超过大流行前的平均水平,其中 4.0%仍为远程医疗。

结论

面对面就诊在大流行早期减少,但在 2020 年 5 月后增加。在 COVID-19 大流行早期,远程医疗的使用迅速增加,随后减少,但仍略高于大流行前水平。

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