Salmon Chase, Bell Kameron, Reyes Eric, Ireland Ellen, Danek Robin
Indiana University School of Medicine, Terre Haute, IN, USA.
Rose-Hulman Institute of Technology, Terre Haute, IN, USA.
BMC Health Serv Res. 2025 Feb 18;25(1):270. doi: 10.1186/s12913-025-12413-5.
The COVID-19 pandemic accelerated the adoption of telemedicine, integrating it into mainstream healthcare, especially in underserved and rural areas. This study examines the implementation and perceptions of telehealth in a rural Midwestern community in the post-pandemic period. Rural populations often face unique healthcare challenges. Telehealth has the potential to mitigate these issues by improving healthcare accessibility and patient satisfaction, thus being a vital topic for research.
A survey was created and conducted from September to October 2023 to evaluate Internet access, telehealth usage, and perceptions among residents of a rural Midwestern county. The county received fiberoptic Internet in November 2021, offering a valuable glimpse at the impact of advanced internet. The survey, distributed both online and in person, garnered 253 valid responses. Statistical analyses, including chi-square tests, were performed using IBM SPSS to explore the relationships between survey responses.
Among the 253 participants, the majority were female (81.4%) with a median age of 50 years. Internet access varied, with 22% of paper survey respondents lacking home Internet compared to 1.3% of online respondents. Telehealth usage for participants increased from 5% pre-pandemic to 42.1% during the pandemic, with 21.8% continuing to use telehealth post-pandemic. Primary care visits were the most common telehealth appointments. Key concerns included a preference for in-person care and perceived lower quality of telehealth services. Despite these concerns, 59.7% of respondents were willing to use telehealth, rising to 67.5% if recommended by a healthcare provider. Comfort with telehealth was significantly linked to perceptions of Internet speed and stability.
While broadband and fiberoptic Internet are associated with better telehealth experiences, other types of Internet also facilitated telehealth usage in our study, indicating that factors beyond access influence patient comfort and willingness to use telehealth. Our findings also reveal significant interest in telehealth for primary care, suggesting rural patients prefer familiar providers for telehealth interactions. Despite increased telehealth interest and usage during the pandemic, a decline post-pandemic indicates potential barriers exist, such as limited availability of healthcare providers. Exploring and addressing these barriers remains crucial for sustaining telehealth adoption and improving healthcare access in rural communities.
新冠疫情加速了远程医疗的应用，将其融入主流医疗保健，尤其是在服务不足的地区和农村地区。本研究考察了疫情后中西部一个农村社区远程医疗的实施情况及相关看法。农村人口往往面临独特的医疗保健挑战。远程医疗有潜力通过提高医疗可及性和患者满意度来缓解这些问题，因此成为一个重要的研究课题。
2023年9月至10月开展了一项调查，以评估中西部一个农村县居民的互联网接入情况、远程医疗使用情况及相关看法。该县于2021年11月接入了光纤互联网，这为了解高速互联网的影响提供了宝贵视角。该调查通过线上和线下两种方式进行分发，共获得253份有效回复。使用IBM SPSS进行了包括卡方检验在内的统计分析，以探究调查回复之间的关系。
在253名参与者中，大多数为女性（81.4%），年龄中位数为50岁。互联网接入情况各不相同，纸质调查问卷的受访者中有22%家中没有互联网，而在线受访者中这一比例为1.3%。参与者的远程医疗使用率从疫情前的5%上升到疫情期间的42.1%，疫情后仍有21.8%的人继续使用远程医疗。初级保健就诊是最常见的远程医疗预约类型。主要担忧包括更倾向于面对面就诊以及认为远程医疗服务质量较低。尽管存在这些担忧，但59.7%的受访者愿意使用远程医疗，如果是医疗服务提供者推荐，这一比例会升至67.5%。对远程医疗的接受程度与对互联网速度和稳定性的看法显著相关。
虽然宽带和光纤互联网与更好的远程医疗体验相关，但在我们的研究中，其他类型的互联网也促进了远程医疗的使用，这表明接入之外的因素会影响患者对远程医疗的接受程度和使用意愿。我们的研究结果还显示出对初级保健远程医疗的浓厚兴趣，这表明农村患者在远程医疗互动中更喜欢熟悉的医疗服务提供者。尽管疫情期间对远程医疗的兴趣和使用率有所增加，但疫情后出现下降，这表明存在潜在障碍，比如医疗服务提供者数量有限。探索并解决这些障碍对于维持农村社区远程医疗的应用和改善医疗可及性仍然至关重要。
