College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Telemed Telecare. 2024 Jul;30(6):993-1004. doi: 10.1177/1357633X221113192. Epub 2022 Jul 26.
During the COVID-19 pandemic, health care shifted to virtual interactions with health professionals. The aim of this study was to examine the determinants of telehealth use in a nationally representative sample of the United States adult population.
The study used data from the 2020 National Health Interview Survey of 17,582 respondents aged ≥18. Andersen's model of health services utilization was employed to examine predisposing, enabling, and needs factors associated with past-year telehealth use. Multivariable logistic regression was conducted to examine statistical associations.
32.5% of adults ( = 6402; mean age 51.6, SE = 0.4) reported telehealth use. Women and married/partnered adults and those with higher levels of education had greater odds of using telehealth. Adults living in Midwest and South and adults living in medium-small and non-metropolitan areas had decreased odds of using telehealth. Income and having a usual source of care were positively associated with telehealth use. A negative association was found for those with no insurance and telehealth use, whereas a positive association was found for military insurance. Odds of using telehealth were increased for adults who had well-visits and ER visits in the past 12 months. Mental health services quadrupled the odds of telehealth use. Odds of using telehealth increased with each additional chronic disease, including COVID-19.
There are disparities in telehealth use according to sex, education, rurality, access to care, and health needs. Tackling these disparities is pivotal to ensure barriers to telehealth use are not exacerbated post-pandemic.
在 COVID-19 大流行期间,医疗保健转向与卫生专业人员进行虚拟互动。本研究旨在调查美国成年人群体中具有代表性的样本中,远程医疗使用的决定因素。
本研究使用了来自 2020 年全国健康访谈调查的 17582 名年龄≥18 岁的受访者的数据。采用安德森卫生服务利用模型,研究了与过去一年使用远程医疗相关的倾向因素、促成因素和需求因素。采用多变量逻辑回归检验统计学关联。
32.5%的成年人( = 6402;平均年龄 51.6,SE = 0.4)报告使用了远程医疗。女性和已婚/伴侣关系的成年人以及受教育程度较高的成年人使用远程医疗的可能性更大。居住在中西部和南部以及居住在中小城市和非大都市地区的成年人使用远程医疗的可能性降低。收入和有常规医疗服务提供者与远程医疗使用呈正相关。没有保险与远程医疗使用呈负相关,而军人保险与远程医疗使用呈正相关。过去 12 个月内进行常规就诊和急诊就诊的成年人使用远程医疗的可能性增加。心理健康服务使远程医疗的使用可能性增加了四倍。患有慢性疾病的成年人,包括 COVID-19,使用远程医疗的可能性增加。
根据性别、教育、农村地区、获得医疗服务的机会和健康需求,远程医疗的使用存在差异。解决这些差异对于确保远程医疗使用障碍在大流行后不会加剧至关重要。