Navarro Brendan J, Chen Ling, Dy Christopher J
Department of Orthopedic Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Division of Biostatistics, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
HSS J. 2024 Nov;20(4):539-543. doi: 10.1177/15563316231207632. Epub 2023 Oct 28.
The use of telemedicine increased greatly following the onset of the COVID-19 pandemic. It is unclear whether and how sociodemographic factors have affected orthopedics patients' use of this technology in the pandemic.
The aim of this study was to determine how patient demographic variability in telemedicine use is influenced by the Area Deprivation Index (ADI) and distance to clinical site among patients seeking care for hip and knee arthritis from orthopedic surgeons.
Demographic data and visit type were collected from the electronic medical record for patients seen in our academic medical center either before or during the COVID-19 pandemic by orthopedic surgeons who specialize in hip and knee arthroplasty. Univariate and multivariate analyses were performed regarding age, race, insurance status, ADI, and distance to a clinical site.
In the COVID era, among 4901 visits with 3124 unique patients, those using telemedicine were younger and more likely to be White compared to those who did not use telemedicine. There was no significant difference in telemedicine use based on ADI, distance to a clinical site, or insurance status.
This retrospective analysis suggests that orthopedic patients who were White and of younger age were more likely to use telemedicine in the first year of the COVID-19 pandemic. There was no statistically significant relationship between distance from a clinical site or ADI and telemedicine use, suggesting that factors other than these are greater contributors to telemedicine utilization in our cohort. Further information is needed to determine how telemedicine may disproportionately limit access to orthopedic care according to these and other patient factors.
在新冠疫情爆发后，远程医疗的使用大幅增加。目前尚不清楚社会人口统计学因素是否以及如何影响骨科患者在疫情期间对这项技术的使用。
本研究的目的是确定在向骨科医生寻求髋膝关节关节炎治疗的患者中，远程医疗使用的患者人口统计学差异是如何受到地区贫困指数（ADI）和到临床地点的距离影响的。
收集了在我们学术医疗中心由专门从事髋膝关节置换术的骨科医生在新冠疫情之前或期间诊治的患者的电子病历中的人口统计学数据和就诊类型。对年龄、种族、保险状况、ADI和到临床地点的距离进行了单因素和多因素分析。
在新冠疫情时代，在4901次就诊的3124名独特患者中，与未使用远程医疗的患者相比，使用远程医疗的患者更年轻，且更有可能是白人。基于ADI、到临床地点的距离或保险状况，远程医疗使用情况没有显著差异。
这项回顾性分析表明，在新冠疫情的第一年，白人及年轻的骨科患者更有可能使用远程医疗。到临床地点的距离或ADI与远程医疗使用之间没有统计学上的显著关系，这表明除了这些因素之外，其他因素对我们队列中的远程医疗使用贡献更大。需要进一步的信息来确定远程医疗如何可能根据这些和其他患者因素不成比例地限制获得骨科护理的机会。
