安大略省 COVID-19 大流行期间基于转诊的远程医疗服务利用的年龄和性别相关比较：回顾性分析。
Age and sex-related comparison of referral-based telemedicine service utilization during the COVID-19 pandemic in Ontario: a retrospective analysis.
机构信息
Department of Pediatrics, Scarborough Health Network, 2867 Ellesmere Rd, Scarborough, Toronto, ON, M1E 4B9, Canada.
University of Toronto Temerty School of Medicine, Toronto, ON, Canada.
出版信息
BMC Health Serv Res. 2023 Dec 7;23(1):1374. doi: 10.1186/s12913-023-10373-2.
BACKGROUND
The COVID-19 pandemic has led to increased utilization of telemedicine services.
METHODS
A retrospective analysis of all referral-based ambulatory telemedicine services in Ontario from November 2019 to June 2021 was collected from the Ontario Health Insurance Plan (OHIP) billing database. Only fee-for-service billings were included in the present analysis. Coincident COVID-19 cases were obtained from Public Health Ontario. Comparisons were made based on age bracket, sex, telemedicine and in-person care.
RESULTS
Billings for telemedicine services in Ontario increased from $1.7 million CAD in November 2019 to $64 million CAD in April 2020 and the proportions reached a mean peak of 72% in April 2020 and declined to 46% in June 2021. A positive correlation was found between the use of telemedicine and COVID-19 cases (p = 0.05). The age group with the highest proportion of telemedicine use was the 10-20-year-olds, followed by the 20-50-year-olds (61 ± 9.0%, 55 ± 7.3%, p = 0.01). Both age groups remained above 50% telemedicine services at the end of the study period. There seemed to be higher utilization by females (females 54.2 ± 8.0%, males 47.9 ± 7.7%, ANCOVA p = 0.05) for all specialties, however, after adjusting for male to female ratio m:f of 0.952:1.0 according to the 2016 census, this was no longer significant.
CONCLUSIONS
The use of telemedicine services remained at a high level across groups, particularly the 10-50-year-olds. There were clear age preferences for using telemedicine. Studying these differences may provide insights into how the delivery of non-hospital-based medicine has changed during the COVID-19 pandemic.
背景
COVID-19 大流行导致远程医疗服务的利用率增加。
方法
从安大略省健康保险计划（OHIP）计费数据库中收集了 2019 年 11 月至 2021 年 6 月期间所有基于转诊的门诊远程医疗服务的回顾性分析。本分析仅包括按服务收费的计费。从安大略省公共卫生局获得了并发 COVID-19 病例。根据年龄组、性别、远程医疗和亲自护理进行比较。
结果
安大略省的远程医疗服务计费从 2019 年 11 月的 170 万加元增加到 2020 年 4 月的 6400 万加元，比例在 2020 年 4 月达到平均峰值 72%，并在 2021 年 6 月下降到 46%。远程医疗的使用与 COVID-19 病例呈正相关（p=0.05）。使用远程医疗比例最高的年龄组是 10-20 岁，其次是 20-50 岁（61±9.0%，55±7.3%，p=0.01）。在研究结束时，这两个年龄组的远程医疗服务使用率仍高于 50%。似乎所有专业的女性利用率都更高（女性 54.2±8.0%，男性 47.9±7.7%，ANCOVA p=0.05），但根据 2016 年人口普查，调整男女比例 m：f 为 0.952：1.0 后，这不再显著。
结论
远程医疗服务的使用率在各群体中仍保持较高水平，特别是 10-50 岁的人群。使用远程医疗存在明显的年龄偏好。研究这些差异可以深入了解在 COVID-19 大流行期间非医院医疗服务的提供方式发生了怎样的变化。
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