居家行医：医生视角下 COVID-19 大流行期间远程医疗的优势
Doctoring from home: Physicians' perspectives on the advantages of remote care delivery during the COVID-19 pandemic.
机构信息
Department of Health Systems Management, College of Health Sciences, Rush University, Chicago, Illinois, United States of America.
Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States of America.
出版信息
PLoS One. 2022 Jun 2;17(6):e0269264. doi: 10.1371/journal.pone.0269264. eCollection 2022.
BACKGROUND
During the COVID-19 pandemic, stay-at-home orders as well as shortages of personal protective equipment forced primary care physicians (PCPs) to transition rapidly from in-person visits to telehealth. While telehealth expanded extensively in a short period of time, research about the consequences of the shift to remote care is lacking. The objective of this qualitative study was to examine how telehealth benefited PCPs and their patients during the COVID-19 pandemic.
METHODS
From July to August 2020, semi-structured interviews were conducted with 20 PCPs associated with a single academic medical center to examine their perspectives about delivering care remotely during the COVID-19 pandemic. All interviews were recorded, transcribed verbatim, coded, and analyzed using deductive thematic analysis.
RESULTS
PCPs identified several benefits of remote care delivery for both physicians and patients. They indicated that (1) patients were reassured that they could receive safe and timely care, (2) remote visits were convenient for patients, (3) patients were comfortable receiving care at home, and (4) video visits enhanced patient- and family-centered care during the COVID-19 pandemic. Participants also noted that (1) telehealth accommodated working from home, (2) physicians were equitably reimbursed for telehealth visits, and that (3) telehealth promoted physician work-life balance.
CONCLUSIONS
Our data provides preliminary evidence that PCPs and their patients had positive experiences with remote care during the early months of the COVID-19 pandemic. Physicians identified opportunities by which telehealth could enhance the delivery of patient-centered care by allowing them to see patients' home environments and to engage family members and caregivers during telehealth visits. More research is needed to understand how to sustain these benefits beyond the global COVID-19 pandemic and ensure patients' needs are met.
背景
在 COVID-19 大流行期间，居家令以及个人防护设备短缺迫使初级保健医生（PCP）迅速从门诊转为远程医疗。虽然远程医疗在短时间内广泛扩展，但缺乏有关转向远程护理后果的研究。本定性研究的目的是研究在 COVID-19 大流行期间远程医疗如何使 PCP 和他们的患者受益。
方法
2020 年 7 月至 8 月，对与一家学术医疗中心相关的 20 名 PCP 进行了半结构化访谈，以研究他们在 COVID-19 大流行期间远程提供护理的观点。所有访谈均进行了录音、逐字记录、编码和分析，采用演绎主题分析。
结果
PCP 确定了远程护理为医生和患者带来的一些好处。他们指出：（1）患者感到放心，可以获得安全且及时的护理；（2）远程就诊对患者来说很方便；（3）患者在家中接受护理感到舒适；（4）视频就诊在 COVID-19 大流行期间增强了以患者和家庭为中心的护理。参与者还注意到：（1）远程医疗适应在家工作；（2）医生获得了远程医疗访问的公平报销；（3）远程医疗促进了医生的工作与生活平衡。
结论
我们的数据初步证明，在 COVID-19 大流行的早期，PCP 和他们的患者对远程护理有积极的体验。医生发现，远程医疗通过允许他们查看患者的家庭环境并在远程医疗访问期间与家庭成员和照顾者互动，为提供以患者为中心的护理提供了机会。需要更多的研究来了解如何在全球 COVID-19 大流行之外维持这些好处，并确保满足患者的需求。
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