Stearns Stephen A, Lee Daniela, Bustos Valeria P, Haddad Anthony, Hassell Natalie, Kim Erin, Foppiani Jose A, Lee Theodore C, Lin Samuel J, Lee Bernard T
Beth Israel Deaconess Medical Center, Division of Plastic and Reconstructive Surgery, Harvard Medical School, Boston, MA 02215, USA.
Cancers (Basel). 2024 Jul 16;16(14):2555. doi: 10.3390/cancers16142555.
To examine how the recent sharp rise in telemedicine has impacted trends in accessibility of breast reconstruction (BR).
A retrospective study reviewed patients who underwent a total mastectomy at our institution from 1 August 2016 to 31 January 2022. By comparing cohorts before and during the widespread implementation of telemedicine, we assessed telehealth's impact on healthcare accessibility, measured by distance from patients' residences to our institution.
A total of 359 patients were included in this study. Of those, 176 received total mastectomy prior to the availability of telemedicine, and 183 in the subsequent period. There were similar baseline characteristics among patients undergoing mastectomy, including distance from place of residence to hospital ( = 0.67). The same proportion elected to receive BR between groups ( = 0.22). Those declining BR traveled similar distances as those electing the procedure, both before the era of widespread telemedicine adoption (40.3 and 35.6 miles, = 0.56) and during the height of telemedicine use (22.3 and 61.3 miles, = 0.26). When tracking follow-up care, significantly more patients during the pandemic pursued at least one follow-up visit with their original surgical team, indicative of the increased utilization of telehealth services.
While the rate of BR remained unchanged during the pandemic, our findings reveal significant shifts in healthcare utilization, highly attributed to the surge in telehealth adoption. This suggests a transformative impact on breast cancer care, emphasizing the need for continued exploration of telemedicine's role in enhancing accessibility and patient follow-up in the post-pandemic era.
探讨近期远程医疗的急剧增长如何影响乳房重建(BR)的可及性趋势。
一项回顾性研究对2016年8月1日至2022年1月31日在我院接受全乳切除术的患者进行了评估。通过比较远程医疗广泛应用之前和期间的队列,我们以患者住所到我院的距离为衡量标准,评估了远程医疗对医疗可及性的影响。
本研究共纳入359例患者。其中,176例在远程医疗可用之前接受了全乳切除术,183例在随后阶段接受了该手术。接受乳房切除术的患者具有相似的基线特征,包括住所到医院的距离(P = 0.67)。两组中选择接受乳房重建的比例相同(P = 0.22)。拒绝乳房重建的患者与选择该手术的患者出行距离相似,在远程医疗广泛应用时代之前(分别为40.3英里和35.6英里,P = 0.56)以及在远程医疗使用高峰期(分别为22.3英里和61.3英里,P = 0.26)均如此。在跟踪后续护理时,疫情期间明显更多患者与原手术团队进行了至少一次随访,这表明远程医疗服务的利用率有所提高。
虽然疫情期间乳房重建率保持不变,但我们的研究结果显示医疗利用情况发生了显著变化,这很大程度上归因于远程医疗采用率的激增。这表明对乳腺癌护理具有变革性影响,强调有必要在大流行后时代继续探索远程医疗在提高可及性和患者随访方面的作用。