Rockholt Mika M, Addae Gifty, Chee Alexander, Chin Wanda, Cuff Germaine, Wang Jing, Umeh Uchenna O, Doan Lisa V
Department of Anesthesiology, Perioperative Care and Pain Management, New York University Grossman School of Medicine, New York, NY, 10016, USA.
Department of Neuroscience & Physiology, Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA.
J Pain Res. 2023 Aug 8;16:2763-2775. doi: 10.2147/JPR.S415415. eCollection 2023.
The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic.
All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) - were analyzed and compared.
In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p <0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p <0.05).
We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.
新冠疫情导致远程医疗的使用急剧增加，克服了一些获得疼痛治疗的地理障碍。然而，远程医疗对不同社会人口群体的影响仍存在不确定性，这促使我们进一步探索。因此，本研究旨在评估新冠疫情期间及之后社会人口因素对远程医疗使用的影响。
回顾性纳入了2019年3月至2021年10月期间，位于疫情中心（美国纽约）的一家大型学术机构疼痛医学科的所有门诊非程序性就诊病例。分析并比较了与新冠疫情相关的三个时间段（封锁前，仅门诊就诊；封锁期间，仅远程医疗就诊；封锁后，提供门诊和远程医疗就诊）的社会人口数据，包括性别、年龄、种族/民族、邮政编码和医疗保险类型。
在整个研究期间，共诊治了12615例患者，其中大多数为女性（58%）。在封锁后时期，42%的患者使用了远程医疗。随访就诊患者、年轻患者、白人患者、居住在离医院较远地区的患者以及私人保险患者在封锁后更有可能使用远程医疗（p<0.05）。老年患者、少数族裔、曼哈顿居民以及医疗保险/医疗补助受助人在封锁后更有可能选择门诊就诊（p<0.05）。
我们发现了疼痛医学中远程医疗使用方面的差异，这可能是由于社会经济因素，如难以获得可靠的互联网接入、设备成本和技术知识。这强调了需要进一步研究，以更好地理解远程医疗使用的原因和障碍。这有助于为政策制定提供信息，以保障在疼痛治疗中公平使用远程医疗。
