Andersen Jennifer A, Felix Holly C, Su Dejun, Selig James P, Ratcliff Shawn, McElfish Pearl A
College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA.
Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.
Int J Telemed Appl. 2022 Jun 28;2022:5953027. doi: 10.1155/2022/5953027. eCollection 2022.
To examine the factors associated with the first use of telehealth during the COVID-19 pandemic using Andersen's Model of Healthcare Utilization. Andersen's Model of Healthcare Utilization allowed the categorization of the independent variables into the following: (1) predisposing factors, including sociodemographic variables and health beliefs; (2) enabling factors, including socioeconomic status and access to care; and (3) need for care, including preexisting or newly diagnosed conditions and reasons to seek out care or to utilize a new mode of care.
Potential respondents ( = 4,077) were identified for recruitment from a volunteer registry in Arkansas. Recruitment emails provided a study description, the opportunity to verify meeting the study's inclusion criteria and to consent for participation, and a link to follow to complete the survey online. The online survey responses were collected between July and August of 2020 ( = 1,137).
Telehealth utilization included two categories: (1) reported the first use of telehealth services during the pandemic, and (2) reported they had never used telehealth. Lower odds of reporting telehealth utilization during the pandemic were associated with race (Black; OR = 0.57, CI [0.33, 0.96]) and education (high School or less; OR = 0.45, CI [0.25, 0.83]). Higher odds of reporting telehealth utilization included having more than one provider (OR = 2.33, CI [1.30, 4.18]), more physical (OR = 1.12, CI [1.00, 1.25]) and mental (OR 1.53, CI [1.24, 1.88]) health conditions, and changes in healthcare delivery during the pandemic (OR = 3.49, CI [2.78, 4.38]).
The results illustrate that disparities exist in Arkansans' utilization of telehealth services during the pandemic. Future research should explore the disparities in telehealth utilization and how telehealth may be used to address disparities in care for Black Arkansans and those with low socioeconomic status.
运用安德森医疗服务利用模型，研究在新冠疫情期间与首次使用远程医疗相关的因素。安德森医疗服务利用模型允许将自变量分类如下：（1） predisposing因素，包括社会人口统计学变量和健康观念；（2） enabling因素，包括社会经济地位和获得医疗服务的机会；（3） 医疗需求，包括既往或新诊断的疾病以及寻求医疗服务或采用新的医疗模式的原因。
从阿肯色州的志愿者登记册中确定潜在受访者（n = 4077）进行招募。招募邮件提供了研究描述、核实是否符合研究纳入标准并同意参与的机会，以及一个可点击的链接以便在线完成调查。在线调查回复于2020年7月至8月期间收集（n = 1137）。
远程医疗利用情况分为两类：（1） 报告在疫情期间首次使用远程医疗服务，以及（2） 报告从未使用过远程医疗。疫情期间报告使用远程医疗的较低几率与种族（黑人；OR = 0.57，CI [0.33, 0.96]）和教育程度（高中或以下；OR = 0.45，CI [0.25, 0.83]）相关。报告使用远程医疗的较高几率包括有不止一位医疗服务提供者（OR = 2.33，CI [1.30, 4.18]）、更多的身体（OR = 1.12，CI [1.00, 1.25]）和精神（OR 1.53，CI [1.24, 1.88]）健康问题，以及疫情期间医疗服务提供方式的变化（OR = 3.49，CI [2.78, 4.38]）。
结果表明，在疫情期间阿肯色州居民对远程医疗服务的利用存在差异。未来的研究应探讨远程医疗利用方面的差异，以及远程医疗如何用于解决阿肯色州黑人及社会经济地位较低者在医疗服务方面的差异。
原文中“predisposing factors”和“enabling factors”未给出更合适的中文对应词，暂保留英文。
