J Health Care Poor Underserved. 2023;34(1):132-145. doi: 10.1353/hpu.2023.0009.
While several studies have documented the rapid growth in telehealth visits during the pandemic, none have examined its relationship with greater overall access to care among vulnerable populations. We use Association of American Medical Colleges' Consumer Survey data to examine the relationship between access to care and telehealth use before and during the pandemic. The proportion of survey respondents who were always able to get medical care when needed was slightly lower in 2020 compared with prior years while telehealth use rose dramatically. Disparities in telehealth use for Medicaid beneficiaries and rural respondents disappeared during the pandemic, but remained for lower-income populations. Before the pandemic, telehealth use was associated with greater access, but not during the pandemic-when it appears to have become a substitute for in-person. After the pandemic, telehealth could once again be an opportunity to supplement access to care, if telehealth policies enacted during the pandemic are made permanent.
虽然有几项研究记录了大流行期间远程医疗访问量的快速增长,但没有一项研究调查过它与弱势人群获得整体医疗服务机会的增加之间的关系。我们利用美国医学院协会消费者调查数据,在大流行之前和期间,研究了医疗服务可及性与远程医疗使用之间的关系。与前几年相比,2020 年需要时总能获得医疗服务的调查受访者比例略有下降,而远程医疗的使用却大幅上升。在大流行期间,医疗补助受益人和农村受访者之间的远程医疗使用差距消失了,但在收入较低的人群中仍然存在。在大流行之前,远程医疗的使用与更大的可及性相关,但在大流行期间并非如此——此时它似乎已成为面对面医疗的替代品。大流行后,如果大流行期间制定的远程医疗政策永久化,远程医疗可能再次成为补充医疗服务可及性的机会。