| Autor: |
Michael C. Kaufman, Julie Xian, Peter D. Galer, Shridhar Parthasarathy, Alexander K. Gonzalez, Katherine Helbig, Sarah McKeown, Marisa S. Prelack, Mark P. Fitzgerald, Sansanee Craig, Salvatore C. Rametta, Sara E. Fridinger, Uzma Sharif, Susan E. Melamed, Marissa DiGiovine, Lawrence Fried, Marissa P. Malcolm, Sudha Kilaru Kessler, Madeline Chadehumbe, Christina L. Szperka, John Chuo, Laurel Caffee, Donna J. Stephenson, Brenda L. Banwell, Ethan Goldberg, Nicholas S. Abend, Ingo Helbig |
| Rok vydání: |
2021 |
| DOI: |
10.1101/2021.12.15.21267868 |
| Popis: |
IntroductionDetermining the long-term impact of telemedicine in care across the diagnostic and age spectrum of child neurology during the COVID-19 pandemic and with the re-opening of outpatient clinics.MethodsAn observational cohort study of 34,837 in-person visits and 14,820 telemedicine outpatient pediatric neurology visits between October 1, 2019 and April 9, 2021. We assessed differences in care across visit types, time-period observed, time between follow-ups, patient portal activation rates and demographic factors.Results26,399 patients were observed in this study (median age 11.4 years [interquartile range, 5.5-15.9]; 13,209 male). We observed a higher proportion of telemedicine for epilepsy (ICD10 G40: OR 1.4, 95% CI 1.3-1.5) and a lower proportion for movement disorders (ICD10 G25: OR 0.7, 95% CI 0.6-0.8; ICD10 R25: OR 0.7, 95% CI 0.6-0.9). Infants were more likely to be seen in-person after re-opening clinics than by telemedicine (OR 1.6, 95% CI 1.5-1.8) as were individuals with neuromuscular disorders (OR 0.6, 95% CI 0.6-0.7). Racial and ethnic minority populations and those with highest social vulnerability had lower rates of telemedicine participation throughout the pandemic (OR 0.8, 95% CI 0.8-0.8; OR 0.7, 95% CI 0.7-0.8).DiscussionTelemedicine implementation was followed by continued use even once in-person clinics were available. Pediatric epilepsy care can often be performed using telemedicine while young children and patients with neuromuscular disorders often require in-person assessment. Prominent barriers for socially vulnerable families and racial and ethnic minorities persist. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
