Telemedicine in an adolescent and young adult medicine clinic: a mixed methods study

BMC Health Services Research

Research

Nancy K. Hills¹  Sara M. Buckelew²  Angela Barney³  Marissa Raymond-Flesch⁴  Sabrina Mendez-Contreras⁵ 

[1] Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, United States;Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, United States;Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, United States;Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Diego, San Diego, United States;Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, United States;Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, United States;School of Medicine, University of California, San Francisco, United States;

关键词: Telehealth;    Telemedicine;    Adolescent;    Young adult;    Parent;    Confidentiality;    Mixed methods;    Adolescent medicine;   

DOI  :  10.1186/s12913-023-09634-x

 received in 2022-12-01, accepted in 2023-06-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAdolescents and young adults are a diverse patient population with unique healthcare needs including sensitive and confidential services. Many clinics serving this population began offering telemedicine during the Covid-19 pandemic. Little is known regarding patient and parent experiences accessing these services via telemedicine.MethodsTo assess for trends and disparities in telemedicine utilization in the first year of the pandemic, we used the electronic health record to obtain patient demographic data from an adolescent and young adult medicine clinic in a large urban academic institution. Characteristics of patients who had accessed telemedicine were compared to those who were only seen in person. Mean age was compared using t-test, while other demographic variables were compared using chi-squared test or Fisher’s exact test. We performed qualitative semi-structured interviews with patients and parents of patients in order to characterize their experiences and preferences related to accessing adolescent medicine services via telemedicine compared to in-person care.ResultsPatients that identified as female, white race, Hispanic/Latinx ethnicity were more likely to have utilized telemedicine. Telemedicine use was also more prevalent among patients who were privately insured and who live farther from the clinic. Although interview participants acknowledged the convenience of telemedicine and its ability to improve access to care for people with geographic or transportation barriers, many expressed preferences for in-person visits. This was based on desire for face-to-face interactions with their providers, and perception of decreased patient and parent engagement in telemedicine visits compared to in-person visits. Participants also expressed concern that telemedicine does not afford as much confidentiality for patients.ConclusionsMore work is needed to address patient and parent preferences for telemedicine as an adjunct modality to in-person adolescent and young adult medicine services. Optimizing quality and access to telemedicine for this patient population can improve overall healthcare for this patient population.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3