TY -的盟Mandal Soumik盟——Wiesenfeld Batia M AU -曼Devin AU -劳伦斯,凯瑟琳盟——Chunara鲁米非盟-甲壳,保罗AU - 11月,欧迪PY - 2022 DA - 2022/10/14 TI -证据对远程医疗的不断变换的卫生保健交付爆发以来COVID-19:回顾性观察研究乔- Res JMIR形式SP - e38661六世- 6 - 10 KW -数字医疗KW -远程医疗KW -急诊KW - COVID-19 KW -医疗保健交付AB -背景:COVID-19大流行早期阶段远程医疗使用激增已得到充分证明。然而，很少有证据考虑到在随后的时期使用远程医疗。目的:本研究旨在评估在纽约市(NYC)的一个大型卫生系统中，基于视频的远程医疗访问在反复流行的大流行浪潮中用于门诊护理和紧急护理的使用模式，以及这对医疗服务的意义。方法:使用2020年1月1日至2022年2月28日患者的回顾性电子健康记录(EHR)数据，纵向跟踪和分析门诊护理专业和紧急护理的远程医疗和亲自就诊量，并将其与大流行前基线(2019年6月至11月)进行比较。将用于区分疑似COVID-19就诊和非COVID-19就诊的诊断代码，以及评估基于COVID-19的远程医疗随时间的使用情况，与同一地理区域(市级)的COVID-19阳性病例总数进行比较。基于变化点分析对时间序列数据进行分段，比较分段间就诊趋势的方差。结果:COVID-19的出现促使紧急护理和门诊护理环境的远程医疗访问数量早期增加。在整个大流行期间，尽管COVID-19病例在大流行期间有所波动，并且恢复了现场临床服务，但COVID-19和非COVID-19疑似就诊的使用水平仍远高于大流行前的基线水平。在每一波大流行浪潮中，对COVID-19疑似就诊使用基于远程医疗的紧急护理服务表现出更大的差异，但在最初的危机期之后，用于门诊护理的远程医疗就诊保持相对稳定。 During the Omicron wave, the use of all visit types, including in-person activities, decreased. Patients between 25 and 34 years of age were the largest users of telemedicine-based urgent care. Patient satisfaction with telemedicine-based urgent care remained high despite the rapid scaling of services to meet increased demand. Conclusions: The trend of the increased use of telemedicine as a means of health care delivery relative to the pre–COVID-19 baseline has been maintained throughout the later pandemic periods despite fluctuating COVID-19 cases and the resumption of in-person care delivery. Overall satisfaction with telemedicine-based care is also high. The trends in telemedicine use suggest that telemedicine-based health care delivery has become a mainstream and sustained supplement to in-person-based ambulatory care, particularly for younger patients, for both urgent and nonurgent care needs. These findings have implications for the health care delivery system, including practice leaders, insurers, and policymakers. Further investigation is needed to evaluate telemedicine adoption by key demographics, identify ongoing barriers to adoption, and explore the impacts of sustained use of telemedicine on health care outcomes and experience. SN - 2561-326X UR - https://formative.www.mybigtv.com/2022/10/e38661 UR - https://doi.org/10.2196/38661 UR - http://www.ncbi.nlm.nih.gov/pubmed/36103553 DO - 10.2196/38661 ID - info:doi/10.2196/38661 ER -