■西班牙裔社区代表了一个庞大的社区,在美国医疗保健系统中经历了不平等。随着系统向数字健康平台发展,评估对西班牙裔社区的潜在影响至关重要.
■这项研究旨在调查人口统计,社会经济,以及导致西班牙裔社区远程医疗使用率低的行为因素。
■我们使用回顾性观察研究设计来检查研究目标。COVID-19研究数据库联盟提供了AnalyticsIQPeopleCore消费者数据和OfficeAlley索赔数据。研究期为2020年3月至2021年4月。多元逻辑回归用于确定使用远程医疗服务的几率。
■我们检查了3,478,287名独特的西班牙裔患者,其中16.6%(577,396人)使用远程医疗。结果表明,年龄在18至44岁之间的患者比65岁以上的患者更有可能使用远程医疗(比值比[OR]1.07,95%CI1.05-1.1;P<.001)。在所有年龄组中,高收入患者使用远程医疗的可能性至少比低收入患者高20%(P<.001);有初级保健医生的患者(P=.01),表现出很高的医疗使用率(P<.001),或对运动感兴趣(P=.03)更有可能使用远程医疗;有不健康行为如吸烟和饮酒的患者使用远程医疗的可能性较小(P<.001)。在65岁及以上的患者中,男性患者使用远程医疗的可能性低于女性患者(OR0.94,95%CI0.93-0.95;P<.001),而年龄在18至44岁之间的男性患者更有可能使用远程医疗(OR1.05,95%CI1.03-1.07;P<.001)。在65岁以下的患者中,全职就业与远程医疗使用呈正相关(P<.001)。年龄在18至44岁之间且具有高中或以下文化程度的患者使用远程医疗的可能性较低2%(OR0.98,95%CI0.97-0.99;P=0.005)。结果还显示,在44岁以上的患者中,与使用WebMD(WebMDLLC)呈正相关(P<.001),而年龄在18至44岁之间(P=.009)和年龄在45至64岁之间(P=.004)的人与电子处方呈负相关。
■这项研究表明,西班牙裔社区的远程医疗使用取决于年龄等因素,性别,教育,社会经济地位,当前的医疗保健参与,和健康行为。为了应对这些挑战,我们提倡涉及医疗专业人员的跨学科方法,保险提供者,以社区为基础的服务积极与西班牙裔社区接触,并促进远程医疗的使用。我们提出以下建议:增加获得健康保险的机会,改善与初级保健提供者的接触,并分配财政和教育资源以支持远程医疗的使用。随着远程医疗越来越多地塑造医疗保健服务,对于专业人员来说,促进使用所有可用的途径来获得护理至关重要。
UNASSIGNED: The Hispanic community represents a sizeable community that experiences inequities in the US health care system. As the system has moved toward digital health platforms, evaluating the potential impact on Hispanic communities is critical.
UNASSIGNED: The
study aimed to investigate demographic, socioeconomic, and behavioral factors contributing to low telehealth use in Hispanic communities.
UNASSIGNED: We used a retrospective observation
study design to examine the
study objectives. The COVID-19 Research Database Consortium provided the Analytics IQ PeopleCore consumer data and Office Alley claims data. The
study period was from March 2020 to April 2021. Multiple logistic regression was used to determine the odds of using telehealth services.
UNASSIGNED: We examined 3,478,287 unique Hispanic patients, 16.6% (577,396) of whom used telehealth. Results suggested that patients aged between 18 and 44 years were more likely to use telehealth (odds ratio [OR] 1.07, 95% CI 1.05-1.1; P<.001) than patients aged older than 65 years. Across all age groups, patients with high incomes were at least 20% more likely to use telehealth than patients with lower incomes (P<.001); patients who had a primary care physician (P=.01), exhibited high medical usage (P<.001), or were interested in exercise (P=.03) were more likely to use telehealth; patients who had unhealthy behaviors such as smoking and alcohol consumption were less likely to use telehealth (P<.001). Male patients were less likely than female patients to use telehealth among patients aged 65 years and older (OR 0.94, 95% CI 0.93-0.95; P<.001), while male patients aged between 18 and 44 years were more likely to use telehealth (OR 1.05, 95% CI 1.03-1.07; P<.001). Among patients younger than 65 years, full-time employment was positively associated with telehealth use (P<.001). Patients aged between 18 and 44 years with high school or less education were 2% less likely to use telehealth (OR 0.98, 95% CI 0.97-0.99; P=.005). Results also revealed a positive association with using WebMD (WebMD LLC) among patients aged older than 44 years (P<.001), while there was a negative association with electronic prescriptions among those who were aged between 18 and 44 years (P=.009) and aged between 45 and 64 years (P=.004).
UNASSIGNED: This
study demonstrates that telehealth use among Hispanic communities is dependent upon factors such as age, gender, education, socioeconomic status, current health care engagement, and health behaviors. To address these challenges, we advocate for interdisciplinary approaches that involve medical professionals, insurance providers, and community-based services actively engaging with Hispanic communities and promoting telehealth use. We propose the following recommendations: enhance access to health insurance, improve access to primary care providers, and allocate fiscal and educational resources to support telehealth use. As telehealth increasingly shapes health care delivery, it is vital for professionals to facilitate the use of all available avenues for accessing care.