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新冠疫情期间直接面向患者的同步远程皮肤病学服务

Direct to Patient Synchronous Teledermatology During COVID-19 Pandemic.

作者信息

Vaishampayan Neil, Trupiano Nicole, Goldberg Rebecca, Zhang Haihan, Tang Michael, Chopra Ahab, Castanedo-Tardan Mari Paz, Renati Sruthi, Tejasvi Trilokraj

机构信息

Department of Dermatology, University of Michigan, Ann Arbor, Michigan USA.

Department of Dermatology, Montefiore Albert Einstein Medical Center, New York, New York, USA.

出版信息

Telemed J E Health. 2024 Aug;30(8):e2327-e2334. doi: 10.1089/tmj.2023.0576. Epub 2024 May 14.

Abstract

During the COVID-19 pandemic, teledermatology became a popular mode of health care delivery. Thus, deciphering which diagnoses are best suited for synchronous video visits is important to guide providers on appropriate patient care. We conducted a retrospective study of 1,647 submitted synchronous video visits from September 1, 2020 to March 31, 2021 at a single, large academic institution. Video visits' follow-up rate was significantly associated with diagnosis subtype ( < 0.001). Compared with patients with skin lesions and nonskin dermatologic conditions, patients with a rash had higher odds of being recommended to have their follow-up visit as a video visit (odds ratio [OR] = 0.222, < 0.001; OR = 0.296, < 0.001). Patients with a rash had lower odds of being recommended to have their follow-up visit as an in-person office visit when compared with skin lesions (OR = 9.679, < 0.001), nonskin dermatologic conditions (OR = 4.055, < 0.001), and other skin dermatologic conditions (OR = 2.23, < 0.01). Demographically, employed, middle-aged patients with private insurance made up the majority of video visit usage. African American patients were less likely to utilize a video visit compared with Asian patients (OR = 2.06, < 0.038). Certain dermatologic diagnoses, most notably rashes, are more conducive to video visit management. Rashes made up 86% of new patient video visits, were more likely to have video visit follow-up if needed and were more likely to not require further follow-up indicating that the management of rashes from initial diagnosis to completion in care is suitable for video visit management.

摘要

在新冠疫情期间,远程皮肤病学成为一种流行的医疗服务提供模式。因此,解读哪些诊断最适合同步视频问诊对于指导医护人员进行恰当的患者护理很重要。我们对2020年9月1日至2021年3月31日在一家大型学术机构提交的1647次同步视频问诊进行了回顾性研究。视频问诊的随访率与诊断亚型显著相关(<0.001)。与有皮肤病变和非皮肤皮肤病的患者相比,皮疹患者被推荐进行视频问诊随访的几率更高(优势比[OR]=0.222,<0.001;OR=0.296,<0.001)。与皮肤病变患者(OR=9.679,<0.001)、非皮肤皮肤病患者(OR=4.055,<0.001)和其他皮肤皮肤病患者(OR=2.23,<0.01)相比,皮疹患者被推荐进行面对面门诊随访的几率更低。从人口统计学角度来看,有私人保险的在职中年患者占视频问诊使用人群的大多数。与亚洲患者相比,非裔美国患者使用视频问诊的可能性较小(OR=2.06,<0.038)。某些皮肤病诊断,最显著的是皮疹,更有利于视频问诊管理。皮疹占新患者视频问诊的86%,如果需要更有可能进行视频问诊随访,并且更有可能不需要进一步随访,这表明从初始诊断到护理结束的皮疹管理适合视频问诊管理。

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