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COVID-19大流行期间的远程医疗应用:初步选择性综述

Telehealth Utilization During the COVID-19 Pandemic: A Preliminary Selective Review.

作者信息

Harju Amelia, Neufeld Jonathan

机构信息

Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

Telemed Rep. 2022 Feb 3;3(1):38-47. doi: 10.1089/tmr.2021.0040. eCollection 2022.

Abstract

The COVID-19 pandemic reduced in-person visit volume and fueled a corresponding explosion in demand for telehealth services, resulting in the enactment of several temporary state and federal policies to allow greater flexibility in delivering telehealth services. This review examines patterns in telehealth utilization during the pandemic by synthesizing available findings from large-scale studies. To be included in this review, studies must be of original research, include data from 2020 or 2021, have a U.S. study population, and analyze telehealth encounter data across multiple payers and health systems. This review includes 10 studies that fully met the inclusion criteria and 29 studies that examined telehealth use during the pandemic, although not from multipayer, multihealth system data sets. All studies were identified using Ovid MEDLINE and Google Scholar. At its peak, telehealth accounted for roughly 15-50% of visits across the various studied populations and data sets. The more telehealth was utilized, the smaller the decrease in overall visit volume. Audio visits tended to be used more often than video visits, and telehealth utilization varied across geographic regions and medical specialties. There were disparities in telehealth use by race, age, income, and other factors. Most telehealth visits during the pandemic would not have been reimbursable without the telehealth policy changes that took place. The variability in telehealth utilization across geographic regions is likely attributed to state-level telehealth policies. Most studies examining disparities in telehealth utilization did not compare disparities from before and during the pandemic, and these disparities may be a characteristic of health care overall rather than of telehealth specifically.

摘要

新冠疫情减少了面对面就诊量,并引发了对远程医疗服务需求的相应激增,导致多个州和联邦出台了几项临时政策,以在提供远程医疗服务方面给予更大灵活性。本综述通过综合大规模研究的现有结果,考察了疫情期间远程医疗的使用模式。要纳入本综述,研究必须是原创研究,包含2020年或2021年的数据,研究人群为美国人群,并分析多个支付方和医疗系统的远程医疗就诊数据。本综述纳入了10项完全符合纳入标准的研究,以及29项考察了疫情期间远程医疗使用情况的研究,不过这些研究并非来自多支付方、多医疗系统的数据集。所有研究均通过Ovid MEDLINE和谷歌学术进行识别。在高峰期,远程医疗在各研究人群和数据集中约占就诊量的15%至50%。远程医疗使用得越多,总体就诊量的下降幅度就越小。音频就诊的使用频率往往高于视频就诊,且远程医疗的使用在不同地理区域和医学专科存在差异。在种族、年龄、收入和其他因素方面,远程医疗的使用存在差异。如果没有发生远程医疗政策变化,疫情期间的大多数远程医疗就诊都无法获得报销。远程医疗使用在地理区域上的差异可能归因于州级远程医疗政策。大多数考察远程医疗使用差异的研究并未比较疫情之前和期间的差异,而且这些差异可能是整个医疗保健的一个特征,而非远程医疗特有的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5db/8989093/0a64cd1dcbe7/tmr.2021.0040_figure1.jpg

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