Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.
Ann Surg Oncol. 2022 Nov;29(12):7267-7276. doi: 10.1245/s10434-022-12259-9. Epub 2022 Jul 27.
The coronavirus disease 2019 (COVID-19) pandemic increased the use of telehealth within medicine. Data on sociodemographic and clinical characteristics associated with telehealth utilization among cancer surgical patients have not been well-defined.
Cancer patients who had a surgical oncology visit at the James Cancer Hospital in March 2020-May 2021 were included. Patient demographic and clinical characteristics were recorded; access to modern information technology was measured using the Digital Divide Index (DDI). A logistic regression model was used to assess odds of receiving a telehealth.
Among 2942 patients, median DDI was 18.2 (interquartile range 17.4-22.1). Patients were most often insured through managed care (n = 1459, 49.6%), followed by Medicare (n = 1109, 37.7%) and Medicaid (n = 267, 9.1%). Overall, 722 patients (24.5%) received at least one telehealth visit over the study period. On multivariable analysis, age (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.80-0.98 per 10-year increase), sex (male vs. female: OR 1.83, 95% CI 1.45-2.32), cancer type (pancreatic vs. breast: OR 9.19, 95% CI 6.38-13.23; colorectal vs. breast: OR 5.31, 95% CI 3.71-7.58), insurance type (Medicare vs. Medicaid: OR 1.58, 95% CI 1.04-2.41) and county of residence (distant vs. neighboring: OR 1.33, 95% CI 1.06-1.66) were associated with increased odds of receiving a telehealth visit. Patients from high DDI counties were not less likely to receive telehealth visits versus patients from low DDI counties (OR 1.15, 95% CI 0.85-1.57).
Several patient sociodemographic and clinical characteristics had an impact on the likelihood of receiving a telehealth visit versus an in-person visit, suggesting that telehealth may not be equally accessible to all surgical oncology patients.
2019 年冠状病毒病（COVID-19）大流行增加了医学领域远程医疗的使用。癌症手术患者中与远程医疗使用相关的社会人口学和临床特征的数据尚未得到很好的定义。
纳入 2020 年 3 月至 2021 年 5 月在詹姆斯癌症医院接受外科肿瘤学就诊的癌症患者。记录患者的人口统计学和临床特征；使用数字鸿沟指数（DDI）衡量获取现代信息技术的情况。使用逻辑回归模型评估接受远程医疗的可能性。
在 2942 名患者中，中位数 DDI 为 18.2（四分位距 17.4-22.1）。患者的保险类型最常见的是管理式医疗（n=1459，49.6%），其次是医疗保险（n=1109，37.7%）和医疗补助（n=267，9.1%）。总体而言，722 名患者（24.5%）在研究期间至少接受了一次远程医疗就诊。多变量分析显示，年龄（每增加 10 岁，比值比 [OR] 0.89，95%置信区间 [CI] 0.80-0.98）、性别（男性与女性：OR 1.83，95%CI 1.45-2.32）、癌症类型（胰腺癌与乳腺癌：OR 9.19，95%CI 6.38-13.23；结直肠癌与乳腺癌：OR 5.31，95%CI 3.71-7.58）、保险类型（医疗保险与医疗补助：OR 1.58，95%CI 1.04-2.41）和居住地县（远郊与邻县：OR 1.33，95%CI 1.06-1.66）与接受远程医疗就诊的可能性增加相关。来自 DDI 较高县的患者与来自 DDI 较低县的患者相比，接受远程医疗就诊的可能性并没有降低（OR 1.15，95%CI 0.85-1.57）。
患者的一些社会人口学和临床特征对接受远程医疗就诊与面对面就诊的可能性有影响，这表明远程医疗可能并非所有外科肿瘤学患者都同样能够获得。
