Raphael Meghna, Abacan Allyssa, Cotter Savannah, Smith Peggy B, Chacko Mariam R
Department of Pediatrics and Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
J Adolesc Health. 2024 Dec;75(6):958-964. doi: 10.1016/j.jadohealth.2024.07.027. Epub 2024 Sep 29.
There is a lack of studies describing reproductive health service use and outcomes with telehealth in publicly funded clinics in community settings for economically disadvantaged adolescents and young adults (AYA). This study sought to compare use of reproductive health services before and during the COVID-19 pandemic and analyze the types and quality of reproductive health-care services for patients who did and did not complete a telehealth visit.
Medical records were reviewed for AYA who sought reproductive health services at 9 urban family planning and school-based clinics. Visit-type differences and associated factors by year of service and among those who did and did not complete telehealth visits were analyzed.
Twenty-seven thousand nine hundred sixty-one unique patients were served between 2019 and 2021. As compared to 2019, in 2020 and 2021, there were significantly fewer visits by minors (<18 years old) versus young adults (18-24 years old) (p < .001), and by those with male versus female natal sex (p < .001). At least one telehealth visit was completed by 17.98% of patients. Telehealth visit completion was more likely in young adults, female, Black, non-Hispanic, and higher-income patients. Telehealth users were more likely to complete annual sexually transmitted infection testing, had a higher number of visits per year, and had higher odds of requiring a return visit within 2 weeks of the index visit (odds ratio 1.5, 95% confidence intervals 1.41-1.76).
Our findings illustrate disparities in telehealth use in this population of economically disadvantaged AYA and provides pragmatic targets for future interventions.
缺乏关于社区环境中由公共资金资助的诊所利用远程医疗为经济弱势青少年和青年成年人（AYA）提供生殖健康服务及结果的研究。本研究旨在比较2019年新冠疫情之前和期间生殖健康服务的使用情况，并分析完成和未完成远程医疗就诊的患者所接受的生殖保健服务的类型和质量。
对在9家城市计划生育和校内诊所寻求生殖健康服务的AYA的病历进行审查。分析了按服务年份以及在完成和未完成远程医疗就诊的人群之间的就诊类型差异及相关因素。
2019年至2021年期间共服务了27961名不同患者。与2019年相比，2020年和2021年，未成年人（<18岁）与青年成年人（18 - 24岁）的就诊次数显著减少（p < .001），出生性别为男性与女性的患者就诊次数也显著减少（p < .001）。17.98%的患者至少完成了一次远程医疗就诊。青年成年人、女性、黑人、非西班牙裔和高收入患者更有可能完成远程医疗就诊。远程医疗用户更有可能完成年度性传播感染检测，每年就诊次数更多，且在首次就诊后2周内需要复诊的几率更高（优势比1.5，95%置信区间1.41 - 1.76）。
我们的研究结果表明了在这一经济弱势AYA人群中远程医疗使用的差异，并为未来的干预措施提供了实际目标。
