RESUMO
The 2019 novel coronavirus (COVID-19) pandemic led to an increase in telemedicine use among physicians, from 15.4% in 2019 to 86.5% in 2021 (1-4). Interest has increased in how telemedicine has affected a physician's ability to deliver quality care similar to an in-person office visit, and in technological barriers to telemedicine use (5). This report describes telemedicine use and challenges among physicians sampled in the 2021 National Electronic Health Records Survey. This report builds upon previous work (4) and describes the use of telemedicine, ability to provide quality care during telemedicine visits, satisfaction with telemedicine, and appropriateness of telemedicine use by physician specialty type.
Assuntos
Médicos , Telemedicina , Estados Unidos , Humanos , Visita a Consultório MédicoRESUMO
OBJECTIVES: To characterize demographics, birth parameters, and social determinants of health among mother-infant dyads affected by neonatal abstinence syndrome (NAS) in Pennsylvania. METHODS: We linked 2018-2019 NAS surveillance data to birth record data using probabilistic methods and then geospatially linked to local social determinants of health data based on residential address. We generated descriptive statistics and used multivariable mixed-effects logistic regression to model the association between maternal characteristics, birth parameters, social determinants of health, and NAS. RESULTS: In adjusted models maternal age > 24, non-Hispanic white race/ethnicity, low educational attainment, Medicaid as payor at delivery, inadequate or no prenatal care, smoking during pregnancy, and low median household income were associated with NAS. We found no significant associations between NAS and county-level measures of clinician supply, number of substance use treatment facilities, or urban/rural designation. CONCLUSIONS FOR PRACTICE: This study characterizes mother-infant dyads affected by NAS using linked non-administrative, population data for Pennsylvania. Results demonstrate a social gradient in NAS and inequity in prenatal care receipt among mothers of infants with NAS. Findings may inform implementation of state-based public health interventions.