目的:在退伍军人健康管理局(VA)检查与视频使用相关的初级保健(PC)团队成员的特征。
方法:使用VA电子数据来识别与任何基于视频的PC访问相关的PC团队特征,在为期三年的研究期间(2019年3月15日-2022年3月15日)。使用了重复年度观测的多级混合效应逻辑回归模型,根据患者和医疗保健系统级别的特征进行调整,学习年。我们包括五个PC团队类别:1.PC提供商(PCP),其中包括医生,执业护士,医师助理,2.护士(RN/LVN/LPN/其他护士),3.心理健康(MH)专家,4.社会工作者(SW),和5.临床药师(PharmacD)。
方法:全国54,494名PC护理团队成员(61,728,154名PC访视;4,916,960名患者),包括14422个PCP,30,273名护士,2,721名MH专家,4,065SWs,还有3013个药房.
结果:平均年龄为46.1(SD=11.3)岁;77.1%为女性。PC团队成员使用视频的百分比从24%到84%不等。在完全调整的模型中,与最年轻的年龄组(18~29岁)相比,年龄较大的临床医生更有可能使用视频(例如:50~59岁年龄组:OR=1.12,95CI:1.07~1.18).与男性相比,女性更有可能使用视频(OR=1.18,95CI:1.14-1.22)。MH专家(OR=7.87,95CI:7.32-8.46),药房(OR=1.16,95CI:1.09-1.25),和SWs(OR=1.51,95CI:1.41-1.61)的可能性更大,而护士(OR=0.65,95CI:0.62-0.67)使用视频的可能性低于PCP。
结论:这项研究强调了MH专家更多的视频使用,SWs,和药房,与PCP相比,护士使用的视频更少。老年和女性临床医生,不管他们的角色,使用更多视频这项研究有助于告知跨学科PC团队成员之间基于视频的交付的护理协调。
OBJECTIVE: To examine primary care (PC) team members\' characteristics associated with video use at the Veterans Health Administration (VA).
METHODS: VA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year
study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and
study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).
METHODS: 54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.
RESULTS: The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18-29 years old) (example: 50-59 age group: OR = 1.12,95%CI:1.07-1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14-1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32-8.46), PharmDs (OR = 1.16,95%CI:1.09-1.25), and SWs (OR = 1.51,95%CI:1.41-1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62-0.67) were less likely to use video compared to PCPs.
CONCLUSIONS: This
study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. This
study helps to inform the care coordination of video-based delivery among interdisciplinary PC team members.