Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Division of Pediatric Plastic and Reconstructive Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 93, Chicago, IL 60611, United States.
J Pediatr Surg. 2022 Dec;57(12):860-864. doi: 10.1016/j.jpedsurg.2022.04.022. Epub 2022 May 7.
Telemedicine has played an increasingly important role in surgical care during the coronavirus disease 2019 (COVID-19) pandemic, yet little is known about its usage and correlation to cost both within and across surgical specialties during the pandemic.
We collected data on telehealth encounters from April 2020 to June 2021 for all surgical specialties at a pediatric academic institution. The percent of total encounters that were telemedicine vs. in-person were analyzed over time. Data on charge and reimbursement were averaged for each encounter type, and the percent difference in average charge and reimbursement was calculated and compared between surgical specialties.
Of the 147,007 surgical clinical visits identified, 6,566 encounters (4.5%) were telemedicine. Usage peaked in April and plateaued in June of 2020. The specialties with the highest total percentages of telemedicine visits were neurosurgery (23.2%) and cardiovascular-thoracic (11.9%). Orthopedics reported the lowest usage at 2%. Charges for in-person encounters were higher for nearly all specialties while reimbursements remained equal.
Our institutional trends reveal that conversion to telemedicine varied across surgical specialty during the COVID-19 pandemic. Charges for in-person encounters were higher than telehealth ones for nearly all specialties, but the reimbursements were fairly the same. Understanding trends in telemedicine volume instigated by and following the pandemic may better prepare pediatric institutions to navigate the accelerated adoption and influence policy changes. This is particularly relevant given the fluctuating impact of the pandemic on healthcare institutions as new strains of COVID-19 emerge.
Level V.
在 2019 年冠状病毒病（COVID-19）大流行期间，远程医疗在外科护理中发挥了越来越重要的作用，但对于大流行期间各外科专业的使用情况及其与成本的相关性知之甚少。
我们从 2020 年 4 月至 2021 年 6 月，在一家儿科学术机构收集了所有外科专业的远程医疗就诊数据。分析了随时间推移远程医疗与面对面就诊的总就诊比例。平均每个就诊类型的收费和报销数据，并计算并比较了各外科专业之间平均收费和报销的差异百分比。
在所确定的 147007 例外科临床就诊中，有 6566 次就诊（4.5%）为远程医疗。使用率在 2020 年 4 月达到峰值，并在 6 月趋于平稳。远程医疗就诊总百分比最高的专业是神经外科（23.2%）和心血管胸外科（11.9%）。骨科报告的使用率最低，为 2%。几乎所有专业的面对面就诊收费都较高，而报销则保持不变。
我们机构的趋势表明，COVID-19 大流行期间，各外科专业的远程医疗转型情况各不相同。几乎所有专业的面对面就诊收费都高于远程医疗就诊，但报销金额大致相同。了解大流行期间和之后远程医疗量的变化趋势，可以使儿科机构更好地应对加速采用远程医疗的情况，并影响政策变化。鉴于 COVID-19 对医疗机构的影响不断变化，新的 COVID-19 菌株的出现，这一点尤为重要。
5 级。
