RESUMEN
We performed a retrospective study of cardiology telemedicine visits at a large academic pediatric center between 2016 and 2019 (pre COVID-19). Telemedicine patient visits were matched to data from their previous in-person visits, to evaluate any significant differences in total charge, insurance compensation, patient payment, percent reimbursement and zero reimbursement. Miles were measured between patient's home and the address of previous visit. We found statistically significant differences in mean charges of telemedicine versus in-person visits (2019US$) (172.95 vs 218.27, p=0.0046), patient payment for telemedicine visits versus in-person visits (2019US$) (11.13 vs 62.83, p≤0.001), insurance reimbursement (2019US$) (65.18 vs 110.85, p≤0.001) and insurance reimbursement rate (43% vs 61%, p=0.0029). Rate of zero reimbursement was not different. Mean distance from cardiology clinic was 35 miles. No adverse outcomes were detected. This small retrospective study showed cost reduction and a decrease in travel time for families participating in telemedicine visits. Future work is needed to enhance compensation for telemedicine visits.
Asunto(s)
Atención Ambulatoria , Servicio de Cardiología en Hospital , Enfermedades Cardiovasculares , Costos y Análisis de Costo , Telemedicina , Atención Ambulatoria/economía , Atención Ambulatoria/métodos , Atención Ambulatoria/organización & administración , COVID-19/epidemiología , Servicio de Cardiología en Hospital/economía , Servicio de Cardiología en Hospital/tendencias , Enfermedades Cardiovasculares/economía , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/terapia , Niño , Ahorro de Costo/métodos , Costos y Análisis de Costo/métodos , Costos y Análisis de Costo/estadística & datos numéricos , Salud de la Familia , Femenino , Accesibilidad a los Servicios de Salud/economía , Cardiopatías Congénitas/economía , Cardiopatías Congénitas/epidemiología , Cardiopatías Congénitas/terapia , Humanos , Masculino , Estudios Retrospectivos , SARS-CoV-2 , Telemedicina/economía , Telemedicina/organización & administración , Telemedicina/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
We estimated the main and interactive effects of individual race/ethnicity (black, Hispanic, white) and area race, ethnicity, and poverty (proportions of the female population black, Hispanic, and living below the federal poverty level at the census tract level, respectively) on rates of high-grade cervical lesions among young women. Using data from a statewide surveillance system during 2008-2011, we found a marginally significant interaction (P<0.05) between individual race/ethnicity and area race, with black and Hispanic women living in areas with ≥20% of the female population black having elevated rates compared to those living in areas with <20% of the female population black. These findings indicate a possible synergistic effect between individual race/ethnicity and racial composition in neighborhoods on precancerous cervical lesions.