Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA.
Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, CA, USA.
BMC Prim Care. 2024 Sep 7;25(1):333. doi: 10.1186/s12875-024-02565-4.
To examine primary care (PC) team members' characteristics associated with video use at the Veterans Health Administration (VA).
VA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).
54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.
The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18-29 years old) (example: 50-59 age group: OR = 1.12,95%CI:1.07-1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14-1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32-8.46), PharmDs (OR = 1.16,95%CI:1.09-1.25), and SWs (OR = 1.51,95%CI:1.41-1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62-0.67) were less likely to use video compared to PCPs.
This study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. This study helps to inform the care coordination of video-based delivery among interdisciplinary PC team members.
研究退伍军人事务部（VA）中初级保健（PC）团队成员与视频使用相关的特征。
使用 VA 电子数据，确定在三年研究期间（2019 年 3 月 15 日至 2022 年 3 月 15 日）与任何基于视频的 PC 就诊相关的 PC 团队特征。对重复的年度观察使用多水平混合效应逻辑回归模型，调整患者和医疗系统特征以及研究年份。我们包括五个 PC 团队类别：1. PC 提供者（PCP），包括医生、护士从业者、医师助理，2. 护士（RN/LVN/LPN/其他护士），3. 心理健康（MH）专家，4. 社会工作者（SW），和 5. 临床药剂师（PharmD）。
全国范围内的 54494 名 PC 护理团队成员（61728154 次 PC 就诊；4916960 名患者），包括 14422 名 PCP、30273 名护士、2721 名 MH 专家、4065 名 SW 和 3013 名 PharmD。
平均年龄为 46.1（SD=11.3）岁；77.1%为女性。PC 团队成员中视频使用的比例从 24%到 84%不等。在完全调整的模型中，与最年轻的年龄组（18-29 岁）相比，年龄较大的临床医生更有可能使用视频（例如，50-59 岁年龄组：OR=1.12，95%CI：1.07-1.18）。与男性相比，女性更有可能使用视频（OR=1.18，95%CI：1.14-1.22）。与 PCP 相比，MH 专家（OR=7.87，95%CI：7.32-8.46）、PharmD（OR=1.16，95%CI：1.09-1.25）和 SW（OR=1.51，95%CI：1.41-1.61）更有可能使用视频，而护士（OR=0.65，95%CI：0.62-0.67）则不太可能使用视频。
这项研究强调了 MH 专家、SW 和 PharmD 之间更多的视频使用，以及与 PCP 相比，护士之间更少的视频使用。无论其角色如何，年龄较大和女性临床医生都更多地使用视频。这项研究有助于为跨学科 PC 团队成员的基于视频的交付提供护理协调。
