文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

2022年数字医疗保健使用方面的差异。

Disparities in Digital Health Care Use in 2022.

作者信息

Wakeman Michael, Buckman Dennis W, El-Toukhy Sherine

机构信息

Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, Maryland.

Information Management Services, Calverton, Maryland.

出版信息

JAMA Netw Open. 2025 Apr 1;8(4):e255359. doi: 10.1001/jamanetworkopen.2025.5359.


DOI:10.1001/jamanetworkopen.2025.5359
PMID:40244585
Abstract

IMPORTANCE: Digital health care services expanded with the COVID-19 pandemic. Disparities in telehealth, telemedicine, and telemonitoring use remain understudied. OBJECTIVE: To examine associations between individual-level characteristics and digital health care use and if these associations differ by county-level social vulnerability. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study was an online survey that included a nonprobability sample of US adults aged 18 years or older who resided in 871 counties in the least or most vulnerable quartiles of the Minority Health Social Vulnerability Index (MHSVI), an indicator of county-level social vulnerability. The study was conducted between February and August 2022, and data were analyzed from August 2023 to August 2024. EXPOSURES: Participant characteristics and MHSVI county-level social vulnerability. MAIN OUTCOMES AND MEASURES: Self-reported use of telehealth, telemedicine, and telemonitoring. Multivariable logistic regression models were fit to examine associations between sociodemographic, health, and technology factors and each service use, overall and stratified by MHSVI. RESULTS: Of the 5444 participants who were included in this study, 2927 were female (53.77%), 798 were non-Hispanic Black or African American (14.66%), 838 were Hispanic or Latino (15.39%), 3542 were non-Hispanic White (65.06%); the mean (SE) age was 45.4 (0.2) years. Overall, 2754 participants used telehealth (50.59%), 1609 used telemedicine (29.56%), and 854 used telemonitoring (15.69%). Being English nonproficient (adjusted odds ratio [aOR], 1.54; 95% CI, 1.23-1.92) and having had in-person health care visits (aOR, 4.71; 95% CI, 3.93-5.63) were associated with higher odds of using telehealth, whereas not having a primary care clinician was associated with lower odds (aOR, 0.68; 95% CI, 0.59-0.78). Similar findings were documented for telemedicine and telemonitoring use. Education was associated with higher odds of digital health care use in MHSVI most vulnerable counties (telehealth: aOR, 1.18; 95% CI, 1.06-1.32; telemedicine: aOR, 1.18; 95% CI, 1.05-1.33), whereas individuals who did not self-identify as heterosexual (telehealth: aOR, 1.47; 95% CI, 1.10-1.97; telemedicine: aOR, 1.57; 95% CI, 1.16-2.11; telemonitoring: aOR, 1.54; 95% CI, 1.02-2.31) and those who self-reported fair or poor mental health (telehealth: aOR, 1.29; 95% CI, 1.03-1.61) had higher odds of digital service use in the least vulnerable counties. Self-identifying as Black or African American or Hispanic was associated with high odds of telehealth (Black or African American: aOR, 1.41; 95% CI, 1.17-1.70; Hispanic or Latino: aOR, 1.41; 95% CI, 1.17-1.70), telemedicine (Black or African American: aOR, 1.44; 95% CI, 1.18-1.76; Hispanic or Latino: aOR, 1.27; 95% CI, 1.04-1.54), and telemonitoring (Black or African American: aOR, 1.40; 95% CI, 1.11-1.78; Hispanic or Latino: aOR, 1.46; 95%CI, 1.16-1.84) use overall, but these associations varied across MHSVI strata. CONCLUSIONS AND RELEVANCE: In this cross-sectional study of US adults from MHSVI most and least vulnerable counties, digital health care use varied by participant characteristics. Some traditionally underserved groups self-reported higher use of digital health care. Differing associations between individual-level characteristics and digital health care use by county-level social vulnerability reflect the importance of place-based disadvantage indicators. Eliminating digital health care use disparities is important as it represents a complementary avenue to access health care for underserved populations.

摘要

重要性:随着新冠疫情的爆发,数字医疗服务得到了扩展。远程医疗、远程医学和远程监测使用方面的差异仍未得到充分研究。 目的:研究个体层面特征与数字医疗使用之间的关联,以及这些关联在县级社会脆弱性方面是否存在差异。 设计、设置和参与者:这项横断面研究是一项在线调查,纳入了居住在少数族裔健康社会脆弱性指数(MHSVI)最脆弱或最不脆弱四分位数的871个县中的18岁及以上美国成年人的非概率样本,MHSVI是县级社会脆弱性的一个指标。该研究于2022年2月至8月进行,数据于2023年8月至2024年8月进行分析。 暴露因素:参与者特征和MHSVI县级社会脆弱性。 主要结局和测量指标:自我报告的远程医疗、远程医学和远程监测使用情况。采用多变量逻辑回归模型来研究社会人口学、健康和技术因素与每种服务使用之间的关联,总体分析以及按MHSVI分层分析。 结果:本研究纳入的5444名参与者中,2927名是女性(53.77%),798名是非西班牙裔黑人或非裔美国人(14.66%),838名是西班牙裔或拉丁裔(15.39%),3542名是非西班牙裔白人(65.06%);平均(SE)年龄为45.4(0.2)岁。总体而言,2754名参与者使用过远程医疗(50.59%),1609名使用过远程医学(29.56%),854名使用过远程监测(15.69%)。英语不熟练(调整后的优势比[aOR],1.54;95%置信区间[CI],1.23 - 1.92)以及有过面对面医疗就诊经历(aOR,4.71;95% CI,3.93 - 5.63)与使用远程医疗的较高几率相关,而没有初级保健医生则与较低几率相关(aOR,0.68;95% CI,0.59 - 0.78)。远程医学和远程监测使用也有类似发现。在MHSVI最脆弱的县,教育程度与使用数字医疗的较高几率相关(远程医疗:aOR,1.18;95% CI,1.06 - 1.32;远程医学:aOR,1.18;95% CI,1.05 - 1.33),而在最不脆弱的县,不自我认定为异性恋者(远程医疗:aOR,1.47;95% CI,1.10 - 1.97;远程医学:aOR,1.57;95% CI,1.16 - 2.11;远程监测:aOR,1.54;95% CI,1.02 - 2.31)以及自我报告心理健康状况为一般或较差者(远程医疗:aOR,1.29;95% CI,1.03 - 1.61)使用数字服务的几率较高。总体而言,自我认定为黑人或非裔美国人或西班牙裔与使用远程医疗(黑人或非裔美国人:aOR,1.41;95% CI,1.17 - 1.70;西班牙裔或拉丁裔:aOR,1.41;95% CI,1.17 - 1.70)、远程医学(黑人或非裔美国人:aOR,1.44;95% CI,1.18 - 1.76;西班牙裔或拉丁裔:aOR,1.27;95% CI,1.04 - 1.54)和远程监测(黑人或非裔美国人:aOR,1.40;95% CI,1.11 - 1.78;西班牙裔或拉丁裔:aOR,1.46;95% CI,1.16 - 1.84)的较高几率相关,但这些关联在MHSVI各层中有所不同。 结论和意义:在这项对MHSVI最脆弱和最不脆弱县的美国成年人进行的横断面研究中,数字医疗的使用因参与者特征而异。一些传统上服务不足的群体自我报告使用数字医疗的比例较高。个体层面特征与数字医疗使用之间的关联在县级社会脆弱性方面存在差异,这反映了基于地点的劣势指标的重要性。消除数字医疗使用方面的差异很重要,因为这是为服务不足人群提供医疗服务的一条补充途径。

相似文献

[1]
Disparities in Digital Health Care Use in 2022.

JAMA Netw Open. 2025-4-1

[2]
Differences in Telemedicine Use for Patients With Diabetes in an Academic Versus Safety Net Health System: Retrospective Cohort Study.

J Med Internet Res. 2025-3-24

[3]
Racial and Ethnic and Rural Variations in the Use of Hybrid Prenatal Care in the US.

JAMA Netw Open. 2024-12-2

[4]
Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma.

JAMA Netw Open. 2024-4-1

[5]
Knowledge and Use of Menthol-Mimicking Cigarettes Among Adults in the US.

JAMA Netw Open. 2025-1-2

[6]
Patient Characteristics and Telemedicine Use in the US, 2022.

JAMA Netw Open. 2024-3-4

[7]
Overall and Telehealth Addiction Treatment Utilization by Age, Race, Ethnicity, and Socioeconomic Status in California After COVID-19 Policy Changes.

JAMA Health Forum. 2023-5-5

[8]
A New Measure of Quantified Social Health Is Associated With Levels of Discomfort, Capability, and Mental and General Health Among Patients Seeking Musculoskeletal Specialty Care.

Clin Orthop Relat Res. 2025-4-1

[9]
Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2020.

MMWR Surveill Summ. 2023-5-26

[10]
Factors Associated With Portal and Telehealth Uptake and Use in a Minoritized, Low-Income Community: Mixed Methods Study.

JMIR Form Res. 2025-7-31

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索