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新冠疫情大流行前后初级保健虚拟资源的使用情况。

Primary care virtual resource use prior and post COVID-19 pandemic onset.

机构信息

Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA.

College of Public Health, University of South Florida, Tampa, FL, 33620, USA.

出版信息

BMC Health Serv Res. 2022 Nov 18;22(1):1370. doi: 10.1186/s12913-022-08790-w.

Abstract

BACKGROUND

The COVID-19 pandemic has been a catalyst for rapid uptake of virtual care through the use of virtual health resources (VHR). In the Department of Veterans Affairs (VA) Healthcare System, virtual care has been critical to maintaining healthcare access for patients during COVID-19. In the current study we describe primary care patient aligned care team (PACT) VHR use patterns within one VA medical center (i.e., hospital facility and five community-based outpatient clinics) pre- and post-COVID-19 onset.

METHODS

VHR provider and patient use data from 106 individual PACTs were extracted monthly between September 2019 to September 2020. Data were extracted from VHA web-based project application and tracking databases. Using longitudinal data, mixed effect models were used to compare pre- and post-COVID onset slopes.

RESULTS

Findings highlight an increase in patient users of secure messaging (SM) and telehealth. The rate of utilization among these patients increased for SM but not for telehealth visits or online prescription refill (RxRefill) use. Finally, VetLink Kiosk check ins that are done at in person visits, diminished abruptly after COVID-19 onset.

CONCLUSIONS

These data provide a baseline of VHR use at the PACT level after the initial impact of the COVID-19 pandemic and can inform healthcare delivery changes within the VA systems over time. Moreover, this project produced a data extraction blueprint, that is the first of its kind to track VA VHR use leveraging secondary data sources.

摘要

背景

COVID-19 大流行是通过使用虚拟健康资源(VHR)快速采用虚拟护理的催化剂。在退伍军人事务部(VA)医疗保健系统中,虚拟护理对于在 COVID-19 期间维持患者的医疗保健至关重要。在当前的研究中,我们描述了一个 VA 医疗中心(即医院设施和五个基于社区的门诊诊所)内的初级保健患者医疗团队(PACT)在 COVID-19 发病前后使用 VHR 的模式。

方法

从 2019 年 9 月至 2020 年 9 月,每月从 106 个独立的 PACT 中提取 VHR 提供者和患者使用数据。数据从 VHA 基于网络的项目申请和跟踪数据库中提取。使用纵向数据,混合效应模型用于比较 COVID-19 发病前后的斜率。

结果

研究结果强调了安全消息(SM)和远程医疗患者使用者的增加。这些患者中 SM 的利用率增加,但远程医疗访问或在线处方续药(RxRefill)的利用率并未增加。最后, VetLink 信息亭签到,这是在亲自访问时进行的,在 COVID-19 发病后突然减少。

结论

这些数据提供了 COVID-19 大流行最初影响后 PACT 层面 VHR 使用的基线,并可以随着时间的推移为 VA 系统内的医疗保健提供方式的变化提供信息。此外,该项目制定了数据提取蓝图,这是利用二级数据源跟踪 VA VHR 使用的首例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09ef/9673336/6f82360f9d33/12913_2022_8790_Fig1_HTML.jpg

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