Primary care team characteristics associated with video use: a retrospective national study at the Veterans Health Administration.

Autor: Der-Martirosian C; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA. claudia.der-martirosian@va.gov.; Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, CA, USA. claudia.der-martirosian@va.gov., Yoo CK; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA., Steers WN; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA.; Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, CA, USA., Hou CG; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA., Chu K; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA.; Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, CA, USA., Ferguson J; Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA., Carter M; Office of Primary Care/Patient Care Services, Veterans Health Administration, Washington, DC, USA., Heyworth L; Office of Connected Care/Telehealth Services, Veterans Health Administration, Washington, DC, USA.; Department of Medicine, University of California San Diego School of Medicine, San Diego, CA, USA., Leung LB; Veterans Affairs Greater Los Angeles Healthcare System/Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA.; Department of Medicine, Division of General Internal Medicine & Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: BMC primary care [BMC Prim Care] 2024 Sep 07; Vol. 25 (1), pp. 333. Date of Electronic Publication: 2024 Sep 07.
DOI: 10.1186/s12875-024-02565-4
Abstrakt: 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.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje