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首页> 外文期刊>Journal of the American Board of Family Medicine: JABFM >Not Telehealth: Which Primary Care Visits Need In-Person Care?
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Not Telehealth: Which Primary Care Visits Need In-Person Care?

机译：不是电信：哪个初级保健需要亲自护理？

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摘要

The Coronavirus disease 2019 (COVID 19) pandemic has resulted in a rapid shift to telehealth and many services that need in-person care have been avoided. Yet, as practices and payment policies return to a new normal, there will be many questions about what proportion of visits should be done in-person vs telehealth. Using the 2016 National Ambulatory Medical Survey (NAMCS), we estimated what proportion of visits were amenable to telehealth before COVID-19 as a guide. We divided services into those that needed in-person care and those that could be done via telehealth. Any visit that included at least 1 service where in-person care was needed was counted as an in-person only visit. We then calculated what proportion of reported visits and services in 2016 could have been provided via telehealth, as well as what proportion of in-person only services were done by primary care. We found that 66% of all primary care visits reported in NAMCS in 2016 required an in-person service. 90% of all wellness visits and immunizations were done in primary care offices, as were a quarter of all Papanicolaou smears. As practices reopen, patients will need to catch up on many of the in-person only visits that were postponed such as Papanicolaou smears and wellness visits. At the same time, patients and clinicians now accustomed to telehealth may have reservations about returning to in-person only visits. Our estimates may provide a guide to practices as they navigate how to deliver care in a postCOVID-19 environment.
机译：2019年冠状病毒病（新冠肺炎19）大流行导致了远程医疗的快速转变，许多需要亲自护理的服务都被避免了。然而，随着医疗实践和支付政策恢复到新常态，人们会对当面就诊与远程医疗的比例产生很多疑问。在2019冠状病毒疾病的调查中，我们使用2016次全国性医疗卫生调查（NAMCS），估计了在CVID-19之前的访问量是多少。我们将服务分为需要亲自护理的服务和可以通过远程医疗完成的服务。任何包括至少一项需要当面护理的服务的就诊都被视为仅当面就诊。然后，我们计算了2016年报告的就诊和服务中有多大比例可以通过远程医疗提供，以及有多大比例的个人服务是由初级保健提供的。我们发现，2016年NAMCS报告的所有初级保健就诊中，66%需要亲自服务。90%的健康检查和免疫接种是在初级保健办公室进行的，四分之一的巴氏涂片检查也是如此。随着诊所的重新开放，患者将需要赶上许多被推迟的仅限本人的就诊，如巴氏涂片和健康检查。与此同时，现在习惯于远程医疗的患者和临床医生可能对返回仅限本人的就诊持保留态度。我们的估计可能会为实践提供指导，指导他们如何在后Covid-19环境中提供护理。

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