Claudia Der-Martirosian, Caroline K Yoo, W Neil Steers, Cynthia G Hou, Karen Chu, Jacqueline Ferguson, Maia Carter, Leonie Heyworth, Lucinda B Leung
{"title":"与视频使用相关的初级医疗团队特征:退伍军人健康管理局的一项全国性回顾研究。","authors":"Claudia Der-Martirosian, Caroline K Yoo, W Neil Steers, Cynthia G Hou, Karen Chu, Jacqueline Ferguson, Maia Carter, Leonie Heyworth, Lucinda B Leung","doi":"10.1186/s12875-024-02565-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To examine primary care (PC) team members' characteristics associated with video use at the Veterans Health Administration (VA).</p><p><strong>Methods: </strong>VA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).</p><p><strong>Population: </strong>54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.</p><p><strong>Results: </strong>The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18-29 years old) (example: 50-59 age group: OR = 1.12,95%CI:1.07-1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14-1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32-8.46), PharmDs (OR = 1.16,95%CI:1.09-1.25), and SWs (OR = 1.51,95%CI:1.41-1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62-0.67) were less likely to use video compared to PCPs.</p><p><strong>Conclusions: </strong>This study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. 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Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).</p><p><strong>Population: </strong>54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.</p><p><strong>Results: </strong>The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18-29 years old) (example: 50-59 age group: OR = 1.12,95%CI:1.07-1.18). 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引用次数: 0
摘要
目的研究退伍军人健康管理局(VA)初级保健(PC)团队成员与视频使用相关的特征:使用退伍军人健康管理局的电子数据来确定在三年研究期间(3/15/2019-3/15/2022)与任何基于视频的 PC 访问相关的 PC 团队特征。使用多层次混合效应逻辑回归模型对每年的重复观察结果进行分析,并对患者和医疗系统层面的特征以及研究年份进行调整。我们纳入了五个 PC 团队类别:1.PC提供者(PCP),包括医生、执业护士、医生助理;2.护士(RN/LVN/LPN/其他护士);3.心理健康(MH)专家;4.社会工作者(SW);5.临床药剂师(PharmD):全国 54,494 名 PC 护理团队成员(61,728,154 次 PC 访问;4,916,960 名患者),包括 14,422 名初级保健医生、30,273 名护士、2,721 名心理健康专家、4,065 名社会工作者和 3,013 名药剂师:平均年龄为 46.1(SD = 11.3)岁;77.1% 为女性。PC团队成员使用视频的比例从24%到84%不等。在完全调整模型中,与最年轻的年龄组(18-29 岁)相比,年龄较大的临床医生更有可能使用视频(例如:50-59 岁年龄组:OR = 1.12,95%CI:1.07-1.18)。与男性相比,女性更有可能使用视频(OR = 1.18,95%CI:1.14-1.22)。心理健康专家(OR = 7.87,95%CI:7.32-8.46)、药剂师(OR = 1.16,95%CI:1.09-1.25)和社工(OR = 1.51,95%CI:1.41-1.61)更有可能使用视频,而护士(OR = 0.65,95%CI:0.62-0.67)与初级保健医生相比使用视频的可能性较低:本研究表明,与初级保健医生相比,精神卫生专家、社工和药剂师使用视频的比例更高,而护士使用视频的比例较低。老年和女性临床医生,无论其角色如何,都使用更多视频。这项研究有助于为跨学科个人护理团队成员之间基于视频的护理协调提供信息。
Primary care team characteristics associated with video use: a retrospective national study at the Veterans Health Administration.
Objective: To examine primary care (PC) team members' characteristics associated with video use at the Veterans Health Administration (VA).
Methods: VA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).
Population: 54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.
Results: The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18-29 years old) (example: 50-59 age group: OR = 1.12,95%CI:1.07-1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14-1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32-8.46), PharmDs (OR = 1.16,95%CI:1.09-1.25), and SWs (OR = 1.51,95%CI:1.41-1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62-0.67) were less likely to use video compared to PCPs.
Conclusions: This study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. This study helps to inform the care coordination of video-based delivery among interdisciplinary PC team members.