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不同弱势群体中使用和未使用远程医疗的医疗质量感知比较分析:基于健康信息国家趋势调查的横断面研究

A Comparative Analysis of Healthcare Quality Perception Among Different Vulnerable Populations with and without Telehealth Utilization: A Cross-Sectional Study from the Health Information National Trends Survey.

作者信息

Wang Richard C, Lipin Daniel I, Swoboda Thomas K, Sambamoorthi Usha

机构信息

St. Mark's School of Texas, 10600 Preston Rd, Dallas, TX, 75230, USA.

Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, 657 N. Town Center Drive, Las Vegas, NV, 89144, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Aug 5. doi: 10.1007/s40615-024-02116-8.

Abstract

OBJECTIVE

The COVID-19 pandemic led to a rapid expansion of telehealth utilization in medicine. However, the quality measures associated with telehealth use remain unclear, particularly among vulnerable populations. This study aims to investigate the impact of telehealth on individuals' perception of overall quality care among vulnerable patient populations.

METHODS

This cross-sectional study utilized Health Information National Trends Survey data. The individuals' overall perception of healthcare quality was compared between populations that had at least one telehealth visit and non-telehealth users, who all had the option of utilizing telehealth. This comparison focused on vulnerable populations, considering differences in race and ethnicity (non-Hispanic white vs. non-Hispanic black/Hispanic individuals) and socioeconomic status (high vs. low). Multivariable logistic regressions were employed to ascertain the association between individuals' overall perceptions of quality care with and without telehealth utilization.

RESULTS

A total of 2920 participants, representing an unweighted population of 114,608,302, were analyzed. The adjusted odds ratio (AOR) for at least one telehealth visit associated with individuals' overall perception of quality care among the entire survey population was 0.76 with a 95% CI of 0.51-1.13 (p = 0.173). The AOR was 0.83 (95% CI 0.39-1.77, p = 0.618) among the non-White population, and the AOR was 0.71 (95% CI 0.29-1.78, p = 0.462) among individuals with low SES.

CONCLUSIONS

Although telehealth utilization has both its limitations and advantages compared to traditional clinical visits, no statistically significant differences in individuals' overall perception of quality care were identified among telehealth and non-telehealth users. These findings were also consistent across various vulnerable populations.

摘要

目的

2019年冠状病毒病(COVID-19)大流行导致远程医疗在医学领域的使用迅速扩张。然而,与远程医疗使用相关的质量指标仍不明确,尤其是在弱势群体中。本研究旨在调查远程医疗对弱势群体患者总体医疗质量认知的影响。

方法

这项横断面研究使用了《健康信息国家趋势调查》的数据。比较了至少进行过一次远程医疗就诊的人群与所有都有使用远程医疗选择的非远程医疗用户对医疗质量的总体认知。这种比较聚焦于弱势群体,考虑了种族和族裔差异(非西班牙裔白人 vs. 非西班牙裔黑人/西班牙裔个体)以及社会经济地位差异(高 vs. 低)。采用多变量逻辑回归来确定个体在使用和未使用远程医疗情况下对医疗质量的总体认知之间的关联。

结果

共分析了2920名参与者,代表未加权的114,608,302人的总体。在整个调查人群中,至少进行一次远程医疗就诊与个体对医疗质量的总体认知相关的调整优势比(AOR)为0.76,95%置信区间为(0.51 - 1.13)(p = 0.173)。在非白人人群中,AOR为0.83(95%置信区间0.39 - 1.77,p = 0.618),在社会经济地位低的个体中,AOR为0.71(95%置信区间0.29 - 1.78,p = 0.462)。

结论

尽管与传统临床就诊相比,远程医疗的使用既有局限也有优势,但在远程医疗用户和非远程医疗用户之间,未发现个体对医疗质量的总体认知存在统计学上的显著差异。这些发现在不同弱势群体中也具有一致性。

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