Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Division of General Academic Pediatrics, 3414 Fifth Avenue, CHOB 1st Floor, Pittsburgh, PA, 15213, USA.
Department of Medicine, University of Pittsburgh School of Medicine, 200 Meyran Avenue, Suite 300, Pittsburgh, PA, 15213, USA.
Pediatr Res. 2023 Jul;94(1):185-192. doi: 10.1038/s41390-023-02481-w. Epub 2023 Jan 23.
The aim of this study was to examine pediatric primary care telemedicine visit scheduling and attendance during the first year of telemedicine.
Using electronic health record data from two academic pediatric primary care practices between April 2020-March 2021, we used Pearson χ tests and logistic regression models to identify child-, family-, and appointment-level characteristics associated with scheduled and attended telemedicine appointments.
Among 5178 primary care telemedicine appointments scheduled during the 12-month period, the proportion of appointments scheduled differed over time for children in families with a language preference other than English or Spanish (4% quarter 1 vs. 6% in quarter 4, p = 0.01) and residing in ZIP codes with the lowest household technology access (24% in quarter 1 vs. 19% in quarter 3 (p = 0.01). Four thousand one hundred and forty-eight of 5178 scheduled telemedicine appointments were attended. Likelihood of attending a telemedicine appointment was highest for children in families with a language preference other than English or Spanish (90%, 95% CI 86-94% compared to Spanish 74%, 95% CI 65-84%), and same-day appointments (86%, 95% CI 85-87%). Attendance among families preferring Spanish language was higher in later months compared to earlier months.
We found disparities in scheduling and attending telemedicine appointments, but signs of greater language equity over time.
本研究旨在考察远程医疗实施的第一年中儿科初级保健远程医疗就诊的预约和到诊情况。
使用 2020 年 4 月至 2021 年 3 月期间来自两个学术性儿科初级保健实践的电子健康记录数据，我们使用 Pearson χ 检验和逻辑回归模型来确定与预约和参加远程医疗预约相关的儿童、家庭和预约层面的特征。
在 12 个月期间安排的 5178 次初级保健远程医疗预约中，对于家庭语言偏好不是英语或西班牙语的儿童以及居住在家庭技术接入率最低的邮政编码的儿童，预约安排的比例随时间而变化（第 1 季度为 4%，第 4 季度为 6%，p=0.01）。在 5178 次预约的远程医疗中，有 4148 次预约出席。西班牙语家庭偏好儿童参加远程医疗预约的可能性最高（90%，95%CI 86-94%，而西班牙语为 74%，95%CI 65-84%），其次是当天预约（86%，95%CI 85-87%）。与前几个月相比，偏好西班牙语的家庭在后期预约的出席率更高。
我们发现远程医疗预约的安排和出席存在差异，但随着时间的推移，语言公平性方面出现了一些积极的迹象。
