新冠肺炎期间的虚拟医疗和电子患者沟通:卡塔尔世界杯8强波胆分析加拿大三级癌症中心不公平的横向研究% a Safavi,Amir H % a Lovas,Mike % a Liu,Zhihui Amy % a Melwani,Sheena % a Truong,Tran % a Devonish,Shayla % a Abdelmutti,Nazek % a Sayani,Ambreen % a Rodin,Danielle % a Berlin,Alejandro %+辐射医学项目，玛格丽特公主癌症中心，700大学大道7楼- RMP，多伦多，M5G 2M9，加拿大，14169462983alejandro.berlin@rmp.uhn.ca %K数字健康%K远程医疗%K远程医疗%K电子健康%K肿瘤%K癌症护理%K虚拟医疗%K健康不公平%K健康不平等%K数字鸿沟%K COVID-19 %K电子邮件%K横断面%K敬业度%K满意度%K患者报告%K体验%D 2022 %7 4.11.2022 %9原始论文%J J医疗互联网研究%G英语%X在COVID-19大流行期间，已迅速采用虚拟护理(VC)就诊(电话或视频)和基于电子邮件的患者沟通，以促进癌症护理。随着这些数字卫生工具的普及，获取和患者体验方面的不公平现象可能会出现。目的:我们旨在描述COVID-19大流行期间三级癌症中心采用数字健康工具后在获取和患者报告经验方面的不公平现象。方法:对2020年9月至12月就诊的门诊患者进行横断面研究。整理了患者特征和对基于电子邮件的患者体验调查的反应。在三对对照组中评估访问的不公平:(1)有VC和亲自访问的患者，(2)有和没有记录电子邮件地址的患者，(3)对调查有反应和无反应的患者。在调查应答者中评估患者报告经验的不公平。 Demographics were mapped to area-level averages from national census data. Socioeconomic status was mapped to area-level dimensions of the Canadian Index of Multiple Deprivation. Covariate balance between comparison groups was assessed using standardized mean differences (SMDs), with SMD≥0.2 indicating differences between groups. Associations between patient experience satisfaction scores and covariates were assessed using multivariable analyses, with P<.05 indicating statistical significance. Results: Among the 42,194 patients who had outpatient visits, 62.65% (n=26,435) had at least one VC visit and 31.15% (n=13,144) were emailable. Access to VC and email was similar across demographic and socioeconomic indices (SMD<0.2). Among emailable patients, 21.84% (2870/13,144) responded to the survey. Survey responsiveness was similar across indices, aside from a small difference by age (SMD=0.24). Among responders, 24.4% received VC and were similar to in-person responders across indices (SMD<0.2). VC and in-person responders had similar satisfaction levels with all care domains surveyed (all P>.05). Regardless of visit type, patients had variable satisfaction with care domains across demographic and socioeconomic indices. Patients with higher ethnocultural composition scores were less satisfied with the cultural appropriateness of their care (odds ratio [OR] 0.70, 95% CI 0.57-0.86). Patients with higher situational vulnerability scores were less satisfied with discussion of physical symptoms (OR 0.67, 95% CI 0.48-0.93). Patients with higher residential instability scores were less satisfied with discussion of both physical (OR 0.81, 95% CI 0.68-0.97) and emotional (OR 0.86, 95% CI 0.77-0.96) symptoms, and also with the duration of their visit (OR 0.85, 95% CI 0.74-0.98; P=.02). Male patients were more satisfied with how their health care provider had listened to them (OR 1.64, 95% CI 1.11-2.44; P=.01). Conclusions: Adoption of VC and email can equitably maintain access and patient-reported experience in cancer care across demographics and socioeconomic indices. Existing health inequities among structurally marginalized patients must continue to be addressed to improve their care experience. %M 36331536 %R 10.2196/39728 %U //www.mybigtv.com/2022/11/e39728 %U https://doi.org/10.2196/39728 %U http://www.ncbi.nlm.nih.gov/pubmed/36331536