J Health Care Poor Underserved. 2023;34(2):535-548. doi: 10.1353/hpu.2023.0048.
To determine whether the introduction of telemedicine at a rural pediatric clinic was associated with reduced disparities in visit attendance.
A retrospective cohort study was conducted of all clinic visits from 1 January 2019 to 31 December 2021. Visit types were divided into telemedicine visits, in-person urgent, and in-person non-urgent visits. Visits were stratified into periods based on the statewide pandemic response.
A total of 8,412 patients with 54,746 scheduled visits were analyzed. Visits were less likely to be completed for older patients, Black patients, and patients with Medicaid insurance than their counterparts. Despite a pandemic-era increase in telemedicine utilization, disparities in visit completion that were present in the pre-pandemic era persisted after stay-at-home orders were lifted.
The adoption of telemedicine did not reduce pre-existing disparities in visit attendance. Further work is needed to identify the reasons for the disparities and improve visit attendance of historically disadvantaged patient populations.
确定在农村儿科诊所引入远程医疗是否与就诊参与度的差距缩小有关。
对 2019 年 1 月 1 日至 2021 年 12 月 31 日期间的所有诊所就诊进行回顾性队列研究。就诊类型分为远程医疗就诊、现场紧急就诊和现场非紧急就诊。就诊根据全州大流行应对措施分为不同时期。
共分析了 8412 名患者的 54746 次预约就诊。与对照组相比，老年患者、黑人患者和拥有医疗补助保险的患者的就诊完成率较低。尽管在大流行期间远程医疗的利用率有所增加，但在居家令解除后，大流行前存在的就诊完成率差距仍然存在。
远程医疗的采用并没有减少就诊参与度方面已有的差距。需要进一步努力确定差距的原因，并改善历史上处于不利地位的患者群体的就诊参与率。
