Prahalad Priya, Leverenz Brianna, Freeman Alex, Grover Monica, Shah Sejal, Conrad Barry, Morris Chris, Stafford Diane, Lee Tzielan, Pageler Natalie, Maahs David M
Division of Pediatric Endocrinology, Stanford University, Stanford, CA.
Stanford Diabetes Research Center, Stanford University, Stanford, CA.
Clin Diabetes. 2022 Spring;40(2):153-157. doi: 10.2337/cd20-0123. Epub 2022 Apr 15.
The coronavirus disease 2019 (COVID-19) pandemic necessitated using telehealth to bridge the clinical gap, but could increase health disparities. This article reports on a chart review of diabetes telehealth visits occurring before COVID-19, during shelter-in-place orders, and during the reopening period. Visits for children with public insurance and for those who were non-English speaking were identified. Telehealth visits for children with public insurance increased from 26.2% before COVID-19 to 37.3% during shelter-in-place orders and 34.3% during reopening. Telehealth visits for children who were non-English speaking increased from 3.5% before COVID-19 to 17.5% during shelter-in-place orders and remained at 15.0% during reopening. Pandemic-related telehealth expansion included optimization of workflows to include patients with public insurance and those who did not speak English. Increased participation by those groups persisted during the reopening phase, indicating that prioritizing inclusive telehealth workflows can reduce disparities in access to care.
2019年冠状病毒病（COVID-19）大流行使得远程医疗成为弥合临床差距的必要手段，但这可能会加剧健康不平等。本文报告了一项对COVID-19之前、就地避难令期间以及重新开放期间糖尿病远程医疗就诊情况的图表审查。确定了有公共保险的儿童以及非英语母语儿童的就诊情况。有公共保险的儿童的远程医疗就诊比例从COVID-19之前的26.2%增加到就地避难令期间的37.3%，在重新开放期间为34.3%。非英语母语儿童的远程医疗就诊比例从COVID-19之前的3.5%增加到就地避难令期间的17.5%，在重新开放期间保持在15.0%。与大流行相关的远程医疗扩展包括优化工作流程，以纳入有公共保险的患者和非英语母语患者。这些群体在重新开放阶段的参与度持续增加，这表明优先考虑包容性的远程医疗工作流程可以减少获得医疗服务方面的不平等。
