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2019 年美国急诊部门的儿科远程医疗使用情况。

Pediatric Telehealth Use in U.S. Emergency Departments in 2019.

机构信息

Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, USA.

出版信息

Telemed J E Health. 2023 Apr;29(4):551-559. doi: 10.1089/tmj.2022.0310. Epub 2022 Sep 13.

Abstract

Little is known about the recent usage of pediatric telehealth across all emergency departments (EDs) in the United States. Building upon our prior work, we aimed to characterize the usage of ED pediatric telehealth in the pre-COVID-19 era. The 2019 National ED Inventory-USA survey characterized all U.S. EDs open in 2019. Among EDs reporting receipt of pediatric telehealth services, we selected a random sample ( = 130) for a second survey on pediatric telehealth usage (2019 ED Pediatric Telehealth Survey). We also recontacted a random sample of EDs that responded to a prior, similar 2017 ED Pediatric Telehealth Survey ( = 107), for a total of 237 EDs in the 2019 ED Pediatric Telehealth Survey sample. Overall, 193 (81%) of the 237 EDs responded to the 2019 Pediatric Telehealth Survey. There were 149 responding EDs that confirmed pediatric telehealth receipt in 2019. Among these, few reported ever having a pediatric emergency medicine (PEM) physician (10%) or pediatrician (9%) available for emergency care. Although 96% of EDs reported availability of pediatric telehealth services 24 h per day, 7 days per week, the majority (60%) reported using services less than once per month and 20% reported using services every 3-4 weeks. EDs most frequently used pediatric telehealth to assist with placement and transfer coordination (91%). Most EDs receiving pediatric telehealth in 2019 had no PEM physician or pediatrician available. Most EDs used pediatric telehealth services infrequently. Understanding barriers to assimilation of telehealth once adopted may be important to enable improved access to pediatric emergency care expertise.

摘要

关于美国所有急诊部(ED)近期儿科远程医疗的使用情况知之甚少。在我们之前工作的基础上,我们旨在描述 COVID-19 之前儿科远程医疗在 ED 中的使用情况。2019 年全国 ED 库存-美国调查描述了 2019 年开放的所有美国 ED。在报告接收儿科远程医疗服务的 ED 中,我们为儿科远程医疗使用情况的第二次调查(2019 年 ED 儿科远程医疗调查)选择了一个随机样本(n=130)。我们还重新联系了对之前类似的 2017 年 ED 儿科远程医疗调查做出回应的随机样本 ED(n=107),总共有 237 个 ED 参加了 2019 年 ED 儿科远程医疗调查。总体而言,237 个 ED 中有 193 个(81%)对 2019 年儿科远程医疗调查做出了回应。有 149 个回应的 ED 确认在 2019 年收到了儿科远程医疗。在这些 ED 中,很少有报告称有儿科急诊医学(PEM)医生(10%)或儿科医生(9%)可用于紧急护理。尽管 96%的 ED 报告称每天 24 小时、每周 7 天提供儿科远程医疗服务,但大多数(60%)报告称每月使用服务不到一次,20%报告称每 3-4 周使用一次。ED 最常使用儿科远程医疗来协助安置和转介协调(91%)。2019 年接收儿科远程医疗的大多数 ED 没有 PEM 医生或儿科医生。大多数 ED 很少使用儿科远程医疗服务。了解采用远程医疗后整合的障碍可能很重要,这有助于改善获得儿科急诊护理专业知识的机会。

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