Telemedicine reports最新文献

Community-acquired pneumonia (CAP) is a leading infectious disease in children, with management guidelines emphasizing clinical judgment over routine imaging. The COVID-19 pandemic accelerated telehealth adoption, raising questions about its impact on pediatric CAP care. We conducted a retrospective database study within primary care, comparing chest X-ray use for CAP diagnosis during three lockdown periods (2020-2021) with corresponding pre-pandemic periods (2018-2019). Children aged 1-14 years with CAP diagnoses were included (n = 3,499 pre-pandemic; n = 438 during lockdown). Remote consultations increased significantly (1.7% vs. 11.6%, p < 0.001), while chest X-ray referrals remained stable, and antibiotic use also stayed consistent. Predictors for imaging shifted: pre-pandemic, older age and longer travel distance were significant factors, whereas during lockdown, only higher socioeconomic status was associated. The ongoing use of telemedicine after COVID-19 offers an opportunity to develop strategies that improve diagnostic confidence and encourage "choosing wisely" in pediatric pneumonia diagnosis.

Background: Physical activity has been shown to improve the health of middle-aged women and prevent menopause-associated disorders. Considering advances in technology, investigating the effects of exercises, especially walking, on the health of menopausal women using a mobile application is crucial. Therefore, this study aimed to implement a 12-week walking program for menopausal women using a mobile application (WalkON) and to investigate changes in health conditions, lifestyle habits, social support and mental health, health-promoting behaviors, health beliefs, and self-efficacy.

Methods: This observational study, utilizing a nonequivalent control group and pre- to post-test design, was conducted between September 9, 2024, and November 11, 2024, with the intervention group consisting of 46 participants and the control group consisting of 45 participants. SPSS software was used to analyze the data.

Results: The findings revealed that, compared with those in the control group, sleep quality scores in the intervention group decreased significantly following the walking intervention, indicating that sleep quality improved in the intervention group (p < 0.05). In addition, changes in depression levels were also significant between the two groups (p < 0.001). Among the health-promoting behavior subfactors, there was a significant difference between the two groups in the health responsibility domain (p < 0.01). There was also a significant difference in the nutrition domain between the intervention and control groups (p < 0.05). Similarly, a significant difference between the two groups was found in the self-efficacy domain (p < 0.05).

Discussion: WalkONs have potential positive effects on health-promoting behaviors and mental health improvement, and could serve as an effective strategy to improve physical and mental health in women experiencing menopausal symptoms.

Purpose: This study examines telemedicine as a sustainable service innovation that combines health, environmental and convenience benefits. It explores how these perceived benefits influence attitudes and intentions to use telemedicine and how trust in the provider shapes this relationship.

Design/methodology: A cross-sectional online survey was conducted with 400 adults who had used or planned to use telemedicine. Data were analyzed using partial least squares structural equation modeling with 5,000 bootstraps.

Findings: Perceived environmental (β = 0.318, p < 0.001), health (β = 0.267, p < 0.001) and convenience benefits (β = 0.231, p < 0.001) all positively affected attitudes toward telemedicine. Attitude, in turn, predicted behavioral intention (β = 0.412, p < 0.001). Trust in provider strengthened the link between attitude and intention (β = 0.073, p = 0.002). The model explained 69% of variance in attitude and 74% in intention (R ² = 0.69; R ² = 0.74).

Practical implications: Results show that emphasizing both health and environmental value can enhance public acceptance of telemedicine.

Originality/value: By integrating sustainable marketing logic with the Theory of Planned Behavior, this study highlights telemedicine's role in advancing eco-efficient, patient-centered health care adoption.

Background: With the rapid expansion of telemedicine services during the COVID-19 pandemic, concerns have emerged about equitable access for vulnerable populations, including older adults. This narrative literature review aims to examine patterns of telemedicine use among older adults during the COVID-19 pandemic in the United States (U.S.).

Methods: A comprehensive review of 55 articles published between 2020 and 2024 was conducted to analyze disparities in older adult telemedicine use around the COVID-19 pandemic. Data from electronic health records and medical claims data were compiled for analysis. Variations based on visit modalities, geographic regions and divisions, age categorization, and medical specialties were explored.

Results: Most studies found lower use among older adults, with 23 reporting significantly reduced usage compared with younger groups. Only 11 showed higher use, while 12 found no difference or had inconclusive results, and 11 did not include an in-person comparison group. A total of 26 studies used a single cross-sectional design, and 29 used multiple cross-sectional designs. Research was primarily conducted in the Northeast and West, U.S., with most studies analyzing telephone, video, and in-person visits (n = 35) and electronic health record data (n = 48).

Conclusions: This review reveals persistent disparities in telemedicine use among older adults during the COVID-19 pandemic, highlighting the need for research into contributing factors and targeted strategies to improve access. Policymakers should consider initiatives such as financial support, broadband expansion, and digital literacy programs to promote equity.

Objective: This study assesses the cost-minimization of the RegulaSUS telemedicine program, reducing the necessity for face-to-face specialist consultations.

Methods: A cost analysis study, utilizing a retrospective cohort design, was conducted from January 2017 to December 2019. The gatekeeping process for waiting lists for specialized consultations was performed by two groups: the RegulaSUS program through telemedicine intervention and those regulated by the usual procedures of the Ambulatory Regulation Center of the State of Rio Grande do Sul (the contemporaneous controls group). The primary outcome was to evaluate the financial impact of the RegulaSUS program on the health system costs using the Time-Driven Activity-Based Costing (TDABC) method.

Results: The RegulaSUS program substantially reduced health care and societal expenditures, with gatekeeping by telemedicine costing $85.02 versus $214.45 for usual procedures-a 60% reduction. This intervention resulted in societal savings of R$7,833,882.56 over 36 months by successfully managing 15,064 patients within primary care settings, rather than referring them to specialists.

Conclusions: The RegulaSUS program demonstrates a remarkable economic impact by integrating evidence-based gatekeeping protocols with telemedicine infrastructure, effectively decreasing specialist demand. This intervention provides compelling evidence for the potential of telemedicine to optimize health care resource allocation, enhance care coordination, and improve system efficiency. The outcomes present a scalable, financially sustainable model for health system strengthening that merits consideration for broader implementation across Brazil's public health network and adaptation to comparable global health care contexts facing similar resource constraints.

Background: Despite growing professional utilization, there is limited understanding of how allied health students are prepared for telehealth practice through academic coursework and placements. This study investigates students' exposure to telehealth education, their perceptions of preparedness, and the competencies they believe are needed for graduate practice.

Methods: A cross-sectional online survey was conducted between October 2024 and March 2025 across two Australian universities offering 24 allied health courses. The survey, adapted from existing tools and informed by telehealth competency frameworks, collected quantitative and qualitative data on students' telehealth learning experiences, placement exposure, and perceived competency needs. Descriptive statistics and content analysis were used to analyze and interpret the data.

Results: Of the 108 respondents from 21 disciplines, only 30% reported receiving telehealth education in their coursework, with most learning limited to background knowledge and delivered via online lectures or self-directed modules. Practical skills such as telehealth session setup and communication were less frequently taught, and only 9.3% of students were assessed on telehealth competencies. Placement exposure was similarly limited, with 25% of students engaging in telehealth activities, primarily through observation. Students rated placement support more positively than coursework preparation. Content analysis revealed strong alignment between student-identified graduate competencies and published telehealth frameworks, including technical proficiency, communication, clinical adaptation, and ethical considerations.

Discussion: Findings highlight significant gaps in telehealth education across allied health programs. Students expressed a preference for hands-on, experiential learning and identified a need for structured, competency-based curricula. The lack of assessment and inconsistent integration of telehealth content suggest poor alignment between learning outcomes and educational delivery. Educators should adopt established telehealth competency frameworks and enhance both academic and placement-based training to better prepare students for using telehealth in contemporary practice.

Introduction: Telerehabilitation (TR) can be as effective as in-clinic therapy; however, the implementation of barriers and facilitators to TR is unknown, especially in the underserved and rural population. In addition to TR, self-management support (SMS) interventions have been successful in improving outcomes for stroke survivors using telehealth. We explored the following: (1) Is an intensive multidisciplinary TR intervention combined with SMS feasible to deliver virtual postacute stroke care? (2) Does an intensive TR intervention combined with SMS lead to improvements in level of impairment, functional outcomes, and quality of life? (3) Does an intensive TR intervention combined with SMS impact patient goal attainment? (4) What barriers and facilitators to TR are perceived by stroke survivors?

Methods: Virtually assisted home rehabilitation after acute stroke-2 offered two sessions of rehabilitation therapy, 3 days a week, for 4 weeks, consisting of two of the following disciplines: occupational therapy, physical therapy, or speech therapy. SMS was offered during the first and last session each week. Quantitative outcomes were completed at baseline assessment (week 1), postintervention assessment (week 6), and final assessment (week 10). Following grounded theory, semi-structured qualitative interviews were completed to identify barriers and facilitators of TR.

Results: A total of N = 15 participants were consented into the program. When excluding the 3 participants who withdrew within or before week 1 of intervention, the average weekly number of therapy sessions completed by the remaining 12 participants was 5.6 (standard deviation [SD] 0.79), 5.6 (SD 0.90), 5.2 (SD 2.19), and 4.9 (SD 1.98) for weeks 2-5, respectively. Posterior probability (PP) results indicated very strong (PP >97%) to extreme (PP >99%) support in favor of change over time across most outcomes, including decreased modified Rankin Scale (marginal improvement of -0.731) and Patient Health Questionnaire scores (-3.606) and increased Montreal Cognitive Assessment (+4.178). Nine participants took part in the semi-structured interviews, and two major themes emerged: 1-"Perceived Access/Delivery" and 2-"Perceived Therapy Advantages." In regard to the goal attainment, low sample sizes limited precision for analyses, thus these were not included in analyses.

Conclusion: TR after acute stroke is feasible, though barriers still exist. This study proved to be a safe and attainable option for underserved populations of stroke survivors, demonstrating high attendance, improved outcomes, and no intervention-related adverse events.

Background: This study examined disparities in telehealth utilization across various health care services among adults in California, with particular focus on racial, ethnic, and linguistic differences. While telehealth has emerged as a potential tool for addressing health care disparities, evidence suggests that utilization patterns may exacerbate existing inequities.

Methods: Using the 2021-2022 California Health Interview Survey (n = 45,893) conducted in diverse languages, we employed descriptive statistics and nonlinear Blinder-Oaxaca decomposition to analyze disparities in telehealth utilization. The Blinder-Oaxaca method systematically partitions outcome differences between groups into explained components and unexplained components. We stratified analyses by visit purpose: mental health, primary care, acute care, chronic care, orthopedics, dermatology, and ophthalmology.

Results: Compared with non-Hispanic Whites, African Americans used telehealth 4.1% more (p < 0.01), whereas Hispanics/Latinos and Asians used it 5.9% (p < 0.01) and 11.3% (p < 0.01) less, respectively. For Hispanics/Latinos, approximately 14% of the disparity remained unexplained by measured covariates, while for Asians, 92% was unexplained (p < 0.01). Individuals with limited English proficiency (LEP) were 9.6% (p < 0.01) less likely to use telehealth overall, with 38% of this gap unexplained by measured factors (p < 0.01). The disparity was most pronounced in mental health services, where LEP individuals utilized telehealth 4.9% points less than non-LEP individuals (p < 0.01), with this gap entirely unexplained by sociodemographic factors. Subgroup analysis revealed telehealth utilization disparities between LEP and non-LEP individuals across all language groups, with LEP Spanish speakers using telehealth 4.3% points less than non-LEP Spanish speakers (p < 0.01), LEP Asian language speakers using it 7.3% points less than non-LEP Asian language speakers (p < 0.01), and LEP speakers of other languages using it 7.3% points less than their non-LEP counterparts (p < 0.01).

Discussion: Our findings reveal significant disparities in telehealth utilization associated with race/ethnicity and English proficiency levels, with linguistic barriers most evident in mental health services. The substantial unexplained components in our decomposition analyses suggest that cultural, structural, and linguistic factors beyond socioeconomic factors significantly influence telehealth utilization. These results underscore the need for efforts to develop linguistically appropriate telehealth services, particularly in mental health care. Addressing these barriers is crucial for harnessing telehealth's potential to promote health equity rather than exacerbating existing health disparities in an increasingly digital health care environment.