Sara N Kiani, Logan D Cho, Jashvant Poeran, Lauren Wilson, Haoyan Zhong, Madhu Mazumdar, Jiabin Liu, Alejandro Gonzalez Della Valle, Stavros G Memtsoudis
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引用次数: 1
Abstract
Introduction: Telemedicine was rapidly deployed at the onset of the COVID-19 pandemic. Little has been published on telemedicine in musculoskeletal care prior to the COVID-19 pandemic. This study is aimed at characterizing trends in telemedicine for musculoskeletal care preceding the COVID-19 pandemic.
Methods: This retrospective study used insurance claims from the Truven MarketScan database. Musculoskeletal-specific outpatient visits from 2014 to 2018 were identified using the musculoskeletal major diagnostic category ICD-10 codes. Telemedicine visits were categorized using CPT codes and Healthcare Common Procedure Coding Systems. We described annual trends in telemedicine in the overall dataset and by diagnosis grouping. Multivariable logistic regression modeling estimated the association between patient-specific and telemedicine visit variables and telemedicine utilization.
Results: There were 36,672 musculoskeletal-specific telemedicine visits identified (0.020% of all musculoskeletal visits). Overall, telemedicine utilization increased over the study period (0% in 2014 to 0.05% in 2018). Orthopedic surgeons had fewer telemedicine visits than primary care providers (OR 0.57, 95% CI 0.55-0.59). The proportion of unique patients utilizing telemedicine in 2018 was higher in the south (OR 2.28, 95% CI 2.19-2.38) and west (OR 5.58, 95% CI 5.36-5.81) compared to the northeast. Those with increased comorbidities and lower incomes and living in rural areas had lower rates of telemedicine utilization.
Conclusions: From 2014 to 2018, there was an increase in telemedicine utilization for musculoskeletal visits, in part due to insurance reimbursement and telemedicine regulation. Despite this increase, the rates of telemedicine utilization are still lowest in some of the groups that could derive the most benefit from these services. Establishing this baseline is important for assessing how the roll-out of telemedicine during the pandemic impacted how/which patients and providers are utilizing telemedicine today.
导语:2019冠状病毒病大流行伊始，远程医疗得到了迅速部署。在2019冠状病毒病大流行之前，很少有关于肌肉骨骼护理远程医疗的文章发表。本研究旨在描述COVID-19大流行之前肌肉骨骼护理远程医疗的趋势。方法:本回顾性研究使用来自Truven MarketScan数据库的保险索赔。使用肌肉骨骼主要诊断类别ICD-10代码对2014年至2018年的肌肉骨骼特异性门诊就诊进行识别。使用CPT代码和卫生保健通用程序编码系统对远程医疗就诊进行分类。我们在总体数据集和诊断分组中描述了远程医疗的年度趋势。多变量logistic回归模型估计了患者特异性和远程医疗访问变量与远程医疗利用之间的关联。结果:确定了36672例肌肉骨骼特异性远程医疗就诊(占所有肌肉骨骼就诊的0.020%)。总体而言，远程医疗的使用率在研究期间有所增加(2014年为0%，2018年为0.05%)。骨科医生的远程医疗就诊次数少于初级保健提供者(OR 0.57, 95% CI 0.55-0.59)。2018年使用远程医疗的独特患者比例在南部(OR 2.28, 95% CI 2.19-2.38)和西部(OR 5.58, 95% CI 5.36-5.81)高于东北部。那些合并症增加、收入较低和生活在农村地区的人远程医疗的使用率较低。结论:从2014年到2018年，由于保险报销和远程医疗监管，肌肉骨骼就诊的远程医疗利用率有所增加。尽管有这种增长，但在一些可以从这些服务中获得最大利益的群体中，远程医疗的使用率仍然最低。建立这一基线对于评估大流行期间远程医疗的推出如何影响当今患者和提供者如何/哪些人利用远程医疗非常重要。
期刊介绍：
The overall aim of the International Journal of Telemedicine and Applications is to bring together science and applications of medical practice and medical care at a distance as well as their supporting technologies such as, computing, communications, and networking technologies with emphasis on telemedicine techniques and telemedicine applications. It is directed at practicing engineers, academic researchers, as well as doctors, nurses, etc. Telemedicine is an information technology that enables doctors to perform medical consultations, diagnoses, and treatments, as well as medical education, away from patients. For example, doctors can remotely examine patients via remote viewing monitors and sound devices, and/or sampling physiological data using telecommunication. Telemedicine technology is applied to areas of emergency healthcare, videoconsulting, telecardiology, telepathology, teledermatology, teleophthalmology, teleoncology, telepsychiatry, teledentistry, etc. International Journal of Telemedicine and Applications will highlight the continued growth and new challenges in telemedicine, applications, and their supporting technologies, for both application development and basic research. Papers should emphasize original results or case studies relating to the theory and/or applications of telemedicine. Tutorial papers, especially those emphasizing multidisciplinary views of telemedicine, are also welcome. International Journal of Telemedicine and Applications employs a paperless, electronic submission and evaluation system to promote a rapid turnaround in the peer-review process.
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