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在 COVID-19 大流行期间,智力或其他发育障碍患者与非智力或其他发育障碍患者在远程医疗使用方面的差异。

Differences in Telemedicine Use Between People With and Without an Intellectual or Other Developmental Disability During the COVID-19 Pandemic.

机构信息

University of Utah, Salt Lake City, UT, USA.

Indiana University, Bloomington, IN, USA.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241226540. doi: 10.1177/00469580241226540.

Abstract

Telemedicine utilization of people with an Intellectual or Other Developmental Disability (IDD) during the COVID-19 Pandemic is not well known. This study compares telemedicine utilization of those with and without IDD prior to the pandemic to after it began. Using the Utah All Payers Claims Database from 2019 to 2021, the study identified telemedicine utilization of adults aged 18 to 62 years old in 2019. Propensity score matching was used to minimize observed confounders of subjects with and without IDD in 2019. Negative binomial regression was used to identify factors that were associated with telemedicine utilization. The final number of subjects in the analysis was 18 204 (IDD: n = 6068, non-IDD: n = 12 136 based on 1:2 propensity score matching). The average (SD) age of the subjects was 31 (11.3) years old in 2019. Forty percent of the subjects were female, about 70% of subjects were covered by Medicaid in 2019. Average (SD) number of telemedicine use in 2020 (IDD: 1.96 (5.97), non-IDD: 1.18 (4.90);  < .01) and 2021 (IDD: 2.24 (6.78) vs 1.37 (5.13);  < .01) were higher for the IDD group than the non-IDD group. The regression results showed that the subjects with IDD had 56% more telemedicine encounters than those in the non-IDD group (Incidence Rate Ratio (IRR) = 1.56,  < .01). The growth of telemedicine during the COVID-19 pandemic has the potential to reduce persistent healthcare disparities in individuals with IDD. However, quality of telemedicine should be considered when it is provided to improve health of subjects with IDD.

摘要

在 COVID-19 大流行期间,智力或其他发育障碍(IDD)患者的远程医疗利用情况尚不清楚。本研究比较了大流行前后 IDD 患者和非 IDD 患者的远程医疗利用情况。该研究使用 2019 年至 2021 年来自犹他州所有支付者索赔数据库,确定了 2019 年年龄在 18 至 62 岁之间的成年人的远程医疗利用情况。使用倾向评分匹配最小化了 2019 年 IDD 患者和非 IDD 患者的观察混杂因素。使用负二项式回归确定与远程医疗利用相关的因素。分析中的最终受试者数量为 18204 名(IDD:n=6068,非 IDD:n=12136,基于 1:2 倾向评分匹配)。2019 年受试者的平均(SD)年龄为 31(11.3)岁。40%的受试者为女性,2019 年约 70%的受试者由医疗补助计划覆盖。2020 年(IDD:1.96(5.97),非 IDD:1.18(4.90);  < .01)和 2021 年(IDD:2.24(6.78)比 1.37(5.13);  < .01)的平均(SD)远程医疗使用次数更高ID 组而非非 ID 组。回归结果表明,与非 IDD 组相比,ID 组的远程医疗就诊次数增加了 56%(发病率比(IRR)=1.56,  < .01)。在 COVID-19 大流行期间远程医疗的发展有可能减少 IDD 患者持续存在的医疗保健差距。然而,在向 IDD 患者提供远程医疗时,应考虑其质量,以改善 IDD 患者的健康状况。

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