@文章{信息:doi/10.2196/38661，作者=“Mandal, Soumik和Wiesenfeld, Batia M和Mann, Devin和Lawrence, Katharine和Chunara, Rumi和Testa, Paul和Nov, Oded”，标题=“自COVID-19开始以来远程医疗对医疗保健服务的持续转变的证据:回顾性观察研究”，期刊=“JMIR Form Res”，年=“2022”，月=“10”，日=“14”，卷=“6”，数=“10”，页=“e38661”，关键词=“数字健康;远程医疗;急诊;COVID-19;背景:在COVID-19大流行的早期阶段，远程医疗的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的远程医疗使用随时间的变化，与同一地理区域(城市级别)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。 Results: The emergence of COVID-19 prompted an early increase in the number of telemedicine visits across the urgent care and ambulatory care settings. This use continued throughout the pandemic at a much higher level than the prepandemic baseline for both COVID-19 and non--COVID-19 suspected visits, despite the fluctuation in COVID-19 cases throughout the pandemic and the resumption of in-person clinical services. The use of telemedicine-based urgent care services for COVID-19 suspected visits showed more variance in response to each pandemic wave, but telemedicine visits for ambulatory care have remained relatively steady after the initial crisis period. 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. ", issn="2561-326X", doi="10.2196/38661", url="https://formative.www.mybigtv.com/2022/10/e38661", url="https://doi.org/10.2196/38661", url="http://www.ncbi.nlm.nih.gov/pubmed/36103553" }