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母婴远程医疗的经济与环境污染物影响

Economic and Environmental Pollutant Impact of Maternal-Fetal Telemedicine.

作者信息

Li Valverde Valeria M, Althaus Elizabeth, Horton Lauren, La Rosa Mauricio F, Haeri Sina

机构信息

Universidad Peruana Cayetano Heredia, Lima, Perú.

University of Texas Rio Grande School of Medicine, Brownsville, Texas.

出版信息

Am J Perinatol. 2025 May;42(7):950-954. doi: 10.1055/a-2447-0069. Epub 2024 Oct 23.

DOI:10.1055/a-2447-0069
PMID:39442528
Abstract

The global issue of greenhouse gas emissions has significant implications for the environment and human health. Telemedicine provides a valuable tool for delivering health care while reducing gas emissions by limiting the need for patient travel. However, the environmental effects of telemedicine in high-risk pregnancy populations remain unassessed. The aim of this study was to estimate the economic and environmental impact of an outpatient teleMFM program.This retrospective cohort study examined all visits at three teleMFM clinics more than 90 miles away from the nearest in-person MFM office between October 1, 2021, and May 1, 2022. Travel distances and times were calculated for each appointment between the patient's home, telemedicine clinic, and nearest in-person clinics, using zip code data and Google Maps web-based map calculator tools. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if in-person using inflation-adjusted Internal Revenue Service annual standard mileage reimbursement rate ($0.58 per mile), and the U.S. Environmental Protection Agency Office of Transportation and Air Quality's average annual emissions and fuel consumption for gasoline-fueled passenger vehicles.During the study period, a total number of 2,712 appointments were scheduled, of which 2,454 were kept (cancellations removed) and analyzed. Visiting a teleMFM clinic resulted in 204 miles, 200 minutes, and $118.32 saved per patient visit compared with visiting the nearest in-person clinic. Over a 7-month period, a total of 96.6 metric tons of emissions were saved.This study demonstrates the positive economic and environmental impact of teleMFM utilization in communities remote from in-person care. Given the contribution of greenhouse gas emissions to climate change, such findings may provide strategies for our specialty to make informed policy, advocacy, and business decisions. · Telemedicine is a growing and accessible healthcare option; however, current research on this topic primarily focuses on clinical outcomes and patient satisfaction, overlooking the its environmental impacts.. · Visiting a teleMFM clinic resulted in 204 miles, 200 minutes and 118.32 dollars saved per patient during their pregnancy compared to visiting the nearest in-person clinic. Over the study period a total of 94.6 metric tons of emissions were saved.. · We demonstrate that the widespread deployment of teleMFM programs can not only address the current MFM supply-demand mismatch, but also save families valuable windshield time (travel time and cost) while having a positive impact on the environment..

摘要

全球温室气体排放问题对环境和人类健康有着重大影响。远程医疗提供了一种有价值的工具,在提供医疗保健的同时,通过减少患者出行需求来降低气体排放。然而,远程医疗在高危妊娠人群中的环境影响仍未得到评估。本研究的目的是评估门诊远程母胎医学项目的经济和环境影响。这项回顾性队列研究考察了2021年10月1日至2022年5月1日期间,距离最近的实体母胎医学办公室90多英里远的三家远程母胎医学诊所的所有就诊情况。利用邮政编码数据和谷歌地图在线地图计算器工具,计算了患者家中、远程医疗诊所和最近的实体诊所之间每次预约的出行距离和时间。通过确定参加远程医疗预约所产生的里程报销率和排放量与如果亲自就诊所产生的里程报销率和排放量之间的差异,计算出行成本节省和环境影响,其中亲自就诊的相关数据使用经通胀调整后的美国国税局年度标准里程报销率(每英里0.58美元),以及美国环境保护局交通与空气质量办公室提供的汽油驱动乘用车的年均排放量和燃料消耗数据。在研究期间,共安排了2712次预约,其中2454次(去除取消的预约)被保留并进行分析。与前往最近的实体诊所就诊相比,前往远程母胎医学诊所就诊每次可为每位患者节省204英里的路程、200分钟的时间和118.32美元。在7个月的时间里,总共节省了96.6公吨的排放量。本研究证明了在远离实体医疗服务的社区中利用远程母胎医学具有积极的经济和环境影响。鉴于温室气体排放对气候变化的影响,这些研究结果可能为我们这个专业领域制定明智的政策、开展宣传和做出商业决策提供策略。· 远程医疗是一种不断发展且易于获得的医疗保健选择;然而,目前关于这一主题的研究主要集中在临床结果和患者满意度上,忽视了其环境影响。· 与前往最近的实体诊所就诊相比,在孕期前往远程母胎医学诊所就诊每次可为每位患者节省204英里的路程、200分钟的时间以及118.32美元。在研究期间,总共节省了94.6公吨的排放量。· 我们证明,广泛部署远程母胎医学项目不仅可以解决当前母胎医学的供需不匹配问题,还可以为家庭节省宝贵的路途时间(出行时间和成本),同时对环境产生积极影响。

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