Circ Cardiovasc Qual Outcomes. 2023 Nov;16(11):e000123. doi: 10.1161/HCQ.0000000000000123. Epub 2023 Nov 1.
Enhancing access to care using telehealth is a priority for improving outcomes among older adults with heart failure, increasing quality of care, and decreasing costs. Telehealth has the potential to increase access to care for patients who live in underresourced geographic regions, have physical disabilities or poor access to transportation, and may not otherwise have access to cardiologists with expertise in heart failure. During the COVID-19 pandemic, access to telehealth expanded, and yet barriers to access, including broadband inequality, low digital literacy, and structural barriers, prevented many of the disadvantaged patients from getting equitable access. Using a health equity lens, this scientific statement reviews the literature on telehealth for older adults with heart failure; provides an overview of structural, organizational, and personal barriers to telehealth; and presents novel interventions that pair telemedicine with in-person services to mitigate existing barriers and structural inequities.
利用远程医疗来增强医疗服务的可及性是改善老年心力衰竭患者治疗效果、提高医疗质量和降低成本的当务之急。远程医疗有可能增加那些居住在资源匮乏地区、身体残疾或交通不便、且无法获得心力衰竭专业心脏病专家治疗的患者的医疗服务可及性。在 COVID-19 大流行期间,远程医疗的可及性有所扩大,但宽带不平等、数字素养低和结构性障碍等获取障碍,使许多处于不利地位的患者无法获得公平的服务。本科学声明使用卫生公平视角,回顾了心力衰竭老年患者远程医疗的文献;概述了远程医疗的结构性、组织性和个人障碍;并提出了新的干预措施,将远程医疗与面对面服务相结合,以减轻现有的障碍和结构性不平等。