Petrick Nathalie, Kreuzenbeck Cordula Charlotte Josefine
Gesundheit und Soziales, IU Internationale Hochschule, Erfurt, Germany.
Gesundheitswesen. 2023 Mar;85(3):188-192. doi: 10.1055/a-1999-7390. Epub 2023 Jan 24.
BACKGROUND: In order to manage the Covid-19 pandemic in Germany in March 2020, the government implemented non-pharmaceutical interventions including school closures, case-based measures, social distancing, and a ban of all public events. Under these circumstances, professional societies and associations in the healthcare sector recommended the use of video consultations. The objective of this analysis was to generate statistically relevant insights into the use of video consultations before and during the Covid-19 pandemic METHODS: This study is based on the analysis of a comprehensive claims data set comprising anonymized data of 5.6 million beneficiaries of a large German health insurance fund. The dataset encompassed healthcare claims from 1 January 2019 to 30 June 2020 covering 29,464,913 patient contacts. The claims were divided into video consultations and face-to-face consultations. This paper presents descriptive statistics and analyses associations between variables. RESULTS: In 8,077 out of all contacts, a video consultation had taken place. This translates into 3.12 of 10,000 contacts. There was no significant difference in the utilization of video consultations by gender. However, the age differed significantly (Chi-square:2280.01, Sig: 0.000) between the contacts with or without use of video consultation. There is a significant increase of up to 27 times the use of video consultation in the first lockdown compared to the same month in 2019. CONCLUSIONS: Apparent higher usage of telemedicine by patients in the age group 50 to 64 years and the very low usage in the group of 65 to 74 years shows that the use of video consultation is age sensitive and should be subject to goal-oriented implementation of telemedical offers. The observed increase, however, is small relative to the total number of patient contacts and is not significant. Thus, there is no evidence in this large dataset to support the claim that video consultation had risen dramatically through the Covid-19 pandemic. Qualitative research to determine the factors for patients and general practitioners that lead to or hinder the use of video consultation should help in addressing the slow digitalization in the outpatient sector in Germany.
背景：为应对2020年3月德国的新冠疫情，政府实施了包括学校关闭、基于病例的措施、社交距离限制以及禁止所有公共活动在内的非药物干预措施。在这种情况下，医疗保健领域的专业协会建议使用视频会诊。本分析的目的是对新冠疫情之前和期间视频会诊的使用情况进行具有统计学意义的洞察。 方法：本研究基于对一个综合索赔数据集的分析，该数据集包含一家大型德国健康保险基金560万受益人的匿名数据。该数据集涵盖了2019年1月1日至2020年6月30日期间的医疗保健索赔，涉及29,464,913次患者就诊。索赔被分为视频会诊和面对面会诊。本文呈现了描述性统计数据并分析了变量之间的关联。 结果：在所有就诊中，有8077次进行了视频会诊。这相当于每10000次就诊中有3.12次。视频会诊的使用在性别上没有显著差异。然而，使用或未使用视频会诊的就诊者在年龄上存在显著差异（卡方检验：2280.01，显著性：0.000）。与2019年同月相比，在首次封锁期间视频会诊的使用量显著增加，最高可达27倍。 结论：50至64岁年龄组患者对远程医疗的使用明显较高，而65至74岁年龄组的使用量极低，这表明视频会诊的使用对年龄敏感，应进行有针对性的远程医疗服务实施。然而，观察到的增长相对于患者就诊总数而言较小且不显著。因此，在这个大型数据集中没有证据支持视频会诊在新冠疫情期间大幅增加的说法。开展定性研究以确定导致或阻碍患者和全科医生使用视频会诊的因素，应有助于解决德国门诊部门数字化进程缓慢的问题。
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