Dardashti Navid, Ferguson Jacqueline M, Nicholson Andrew, Heyworth Leonie, Hogan Timothy P, McMahon Nicholas, Slightam Cindie, Zulman Donna M, Sherman Scott E
Virtual Care Consortium of Research, VA New York Harbor Healthcare System, 423 E 23rd St. 15 North, New York, NY 10010 USA.
NYU Grossman School of Medicine, New York, NY USA.
Discov Health Syst. 2025;4(1):80. doi: 10.1007/s44250-025-00256-0. Epub 2025 Jul 9.
The VHA is the largest healthcare system in the US and an early adopter of telehealth. Barriers to adoption may exist among subpopulations of VHA patients.
To identify patterns in use of telehealth by modality, race, rurality, age and priority group before and during the COVID-19 pandemic.
We used data from the VHA Pyramid Analytics database to determine quarterly telehealth utilization rates from October 2015 to March 2023 using a pre-post analysis. Main measures were stratified by race, rurality, age group, and VA priority groups.
Unique patients who used any VHA care within each Fiscal Year of the study period.
N/A.
Quarterly encounters by modality and number of users with one or more Provider to Home (PTH) encounters per 1000 unique patients.
There were 36,315,299 telehealth encounters completed by 4,597,055 users during the analytic period. From October 2015-March 2020, PTH video encounters grew from 3.2% of VHA telehealth encounters to 38%. From April 2020-March 2023, PTH video encounters accounted for 90.7% of VHA telehealth encounters. Uptake of PTH during the pandemic differed significantly between demographic groups. Quarterly users per 1000 unique patients (increase relative to reference group; p-values < 0.01) increased significantly more for urban-residing patients (44.9 relative to rural); Black, Asian, or Multi-Racial patients (Black: 52.1; Asian: 48.2; multi-racial: 57.5 relative to White), younger Veterans (age < 45: 113.0; age 45-64: 80.3 relative to age ≥ 65); and Veterans with major disabilities (127.3 relative to Veterans without special considerations).
With the expansion of PTH telehealth during the pandemic, there was a shift in sociodemographic patterns among patients receiving at-home video-based care. Moving forward, VA may choose to test implementation strategies that target different demographic groups to support equitable access to PTH care.
The online version contains supplementary material available at 10.1007/s44250-025-00256-0.
退伍军人健康管理局（VHA）是美国最大的医疗保健系统，也是远程医疗的早期采用者。VHA患者亚群体中可能存在采用障碍。
确定2019年冠状病毒病（COVID-19）大流行之前和期间，按方式、种族、农村地区、年龄和优先群体划分的远程医疗使用模式。
我们使用VHA金字塔分析数据库的数据，通过前后分析确定2015年10月至2023年3月的季度远程医疗利用率。主要指标按种族、农村地区、年龄组和退伍军人事务部（VA）优先群体进行分层。
在研究期间每个财政年度内使用过任何VHA护理的独特患者。
无。
按方式划分的季度会诊次数，以及每1000名独特患者中进行过一次或多次提供者到家（PTH）会诊的用户数量。
在分析期间，4597055名用户完成了36315299次远程医疗会诊。从2015年10月至2020年3月，PTH视频会诊在VHA远程医疗会诊中的占比从3.2%增至38%。从2020年4月至2023年3月，PTH视频会诊占VHA远程医疗会诊的90.7%。大流行期间不同人口群体对PTH的接受情况存在显著差异。每1000名独特患者中的季度用户数量（相对于参考组的增加；p值<0.01），城市居民患者（相对于农村居民为44.9）、黑人、亚洲人或多种族患者（黑人：52.1；亚洲人：48.2；多种族：相对于白人57.5）、年轻退伍军人（年龄<45岁：113.0；年龄45 - 64岁：相对于年龄≥65岁为80.3）以及有严重残疾的退伍军人（相对于无特殊情况的退伍军人为127.3）的增长更为显著。
随着大流行期间PTH远程医疗的扩展，接受基于家庭视频护理的患者的社会人口模式发生了变化。展望未来，退伍军人事务部可能会选择测试针对不同人口群体的实施策略，以支持公平获得PTH护理。
在线版本包含可在10.1007/s44250 - 025 - 00256 - 0获取的补充材料。
