Access to What for Whom? How Care Delivery Innovations Impact Health Equity.
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
24
07
2022
accepted:
13
12
2022
medline:
19
4
2023
pubmed:
11
1
2023
entrez:
10
1
2023
Statut:
ppublish
Résumé
Achieving health equity (where every person has the opportunity to attain their full health potential) requires the removal of obstacles to health, including barriers to high-quality medical care. Innovations in service delivery can inadvertently maintain, worsen, or introduce inequities. As such, implementation of innovations must be accompanied by a dual commitment to evaluate impact on marginalized groups and to restructure systems that obstruct people from health and healthcare. Understanding the impact innovations have on access to high-quality care is central to this effort. In this Perspective, we join conceptual models of healthcare access and quality with health equity frameworks to conceptualize healthcare receipt as a series of interactions between people and systems unfolding over time. This synthesized model is applied to illustrate the effects of telemedicine on patient, population, and system outcomes. Telemedicine may improve or worsen health equity by altering access to care and by altering quality of care once it is accessed. Teasing out these varied effects is complex and requires considering multilevel influences on the outcome of a care-seeking episode. This synthesized model can be used to inform research, practice, and policy surrounding the equity implications of care delivery innovations more broadly.
Identifiants
pubmed: 36627525
doi: 10.1007/s11606-022-07987-3
pii: 10.1007/s11606-022-07987-3
pmc: PMC9831366
doi:
Types de publication
Research Support, N.I.H., Extramural
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1282-1287Subventions
Organisme : NICHD NIH HHS
ID : R01 HD107153
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.
Références
Uscher-Pines L, Martineau M. Telehealth After COVID-19: Clarifying Policy Goals for a Way Forward. RAND Corporation; January 2021.
Chakawa A, Belzer LT, Perez-Crawford T, Yeh HW. COVID-19, telehealth, and pediatric integrated primary care: disparities in service use. J Pediatr Psychol. 2021.
Eberly LA, Kallan MJ, Julien HM, et al. Patient characteristics associated with telemedicine access for primary and specialty ambulatory care during the COVID-19 pandemic. JAMA Netw Open. 2020;3(12):e2031640.
doi: 10.1001/jamanetworkopen.2020.31640
pubmed: 33372974
pmcid: 7772717
Hoffman LC. Shedding light on telemedicine & online prescribing: the need to balance access to health care and quality of care. Am J Law Med. 2020;46(2-3):237-251.
doi: 10.1177/0098858820933497
pubmed: 32659190
Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126-133.
doi: 10.1016/j.socscimed.2013.06.032
pubmed: 24507917
pmcid: 4269606
Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:18.
doi: 10.1186/1475-9276-12-18
pubmed: 23496984
pmcid: 3610159
Holden RJ, Carayon P, Gurses AP, et al. SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics. 2013;56(11):1669-1686.
doi: 10.1080/00140139.2013.838643
pubmed: 24088063
Carayon P, Wooldridge A, Hoonakker P, Hundt AS, Kelly MM. SEIPS 3.0: human-centered design of the patient journey for patient safety. Appl Ergon. 2020;84:103033.
doi: 10.1016/j.apergo.2019.103033
pubmed: 31987516
pmcid: 7152782
Hogan V, Rowley DL, White SB, Faustin Y. Dimensionality and R4P: A health equity framework for research planning and evaluation in African American populations. Matern Child Health J. 2018;22(2):147-153.
doi: 10.1007/s10995-017-2411-z
pubmed: 29392541
Ford CL, Airhihenbuwa CO. The public health critical race methodology: praxis for antiracism research. Soc Sci Med. 2010;71(8):1390-1398.
doi: 10.1016/j.socscimed.2010.07.030
pubmed: 20822840
Ford CL, Airhihenbuwa CO. Critical Race Theory, race equity, and public health: toward antiracism praxis. Am J Public Health. 2010;100(Suppl 1):S30-35.
doi: 10.2105/AJPH.2009.171058
pubmed: 20147679
pmcid: 2837428
Benjamin R. Race After Technology: Abolitionist Tools for the New Jim Code. Medford, MA: Polity Press; 2019.
Noble SU. Algorithms of Oppression: How Search Engines Reinforce Racism. New York, NY: NYU Press; 2018.
doi: 10.2307/j.ctt1pwt9w5
Owens K, Walker A. Those designing healthcare algorithms must become actively anti-racist. Nat Med. 2020;26(9):1327-1328.
doi: 10.1038/s41591-020-1020-3
pubmed: 32908272
pmcid: 7810137
Lyles CR, Wachter RM, Sarkar U. Focusing on digital health equity. JAMA. 2021;326(18):1795-1796.
doi: 10.1001/jama.2021.18459
pubmed: 34677577
Cheng C, Beauchamp A, Elsworth GR, Osborne RH. Applying the electronic health literacy lens: systematic review of electronic health interventions targeted at socially disadvantaged groups. J Med Internet Res. 2020;22(8):e18476.
doi: 10.2196/18476
pubmed: 32788144
pmcid: 7453328
Samuels-Kalow M, Jaffe T, Zachrison K. Digital disparities: designing telemedicine systems with a health equity aim. Emerg Med J: EMJ. 2021;38(6):474-476.
doi: 10.1136/emermed-2020-210896
pubmed: 33674277
Nouri S, Khoong E, Lyles C, Karliner L. Addressing equity in telemedicine for chronic disease management during the COVID-19 pandemic. NEJM Catalyst, Innovations in Care Delivery. Published May 4, 2020. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
Thomas SB, Quinn SC, Butler J, Fryer CS, Garza MA. Toward a fourth generation of disparities research to achieve health equity. Annu Rev Public Health. 2011;32:399-416.
doi: 10.1146/annurev-publhealth-031210-101136
pubmed: 21219164
pmcid: 3419584
Cu A, Meister S, Lefebvre B, Ridde V. Assessing healthcare access using the Levesqueʼs conceptual framework- a scoping review. In J Equity Health. 2021;20(1):116.
doi: 10.1186/s12939-021-01416-3
Sittig DF, Singh H. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Qual Saf Health Care. 2010;19(Suppl 3):i68-74.
doi: 10.1136/qshc.2010.042085
pubmed: 20959322
Lion KC, Faro EZ, Coker TR. All quality improvement is health equity work: designing improvement to reduce disparities. Pediatrics. 2022;149(Supplement 3):e2020045948E.
doi: 10.1542/peds.2020-045948E
pubmed: 35230431
Thomas SB, Quinn SC, Butler J, Fryer CS, Garza MA. Toward a fourth generation of disparities research to achieve health equity. Annu Rev Public health. 2011;32:399-416.
doi: 10.1146/annurev-publhealth-031210-101136
pubmed: 21219164
pmcid: 3419584
Rodriguez JA, Betancourt JR, Sequist TD, Ganguli I. Differences in the use of telephone and video telemedicine visits during the COVID-19 pandemic. Am J Manag Care. 2021;27(1):21-26.
doi: 10.37765/ajmc.2021.88573
pubmed: 33471458
Pierce RP, Stevermer JJ. Disparities in use of telehealth at the onset of the COVID-19 public health emergency. J Telemed Telecare. 2020: https://doi.org/10.1177/1357633x20963893 .
Drake C, Lian T, Cameron B, Medynskaya K, Bosworth HB, Shah K. Understanding telemedicineʼs “new normal”: variations in telemedicine use by specialty line and patient demographics. Telemed J e-Health: the official journal of the American Telemedicine Association. 2021.
Zachrison KS, Yan Z, Sequist T, et al. Patient characteristics associated with the successful transition to virtual care: lessons learned from the first million patients. J Telemed Telecare. 2021: https://doi.org/10.1177/1357633x211015547 .
Chen EM, Andoh JE, Nwanyanwu K. Socioeconomic and demographic disparities in the use of telemedicine for ophthalmic care during the COVID-19 pandemic. Ophthalmology. 2021.
Duryea EL, Adhikari EH, Ambia A, Spong C, McIntire D, Nelson DB. Comparison between in-person and audio-only virtual prenatal visits and perinatal outcomes. JAMA Netw Open. 2021;4(4):e215854.
doi: 10.1001/jamanetworkopen.2021.5854
pubmed: 33852002
pmcid: 8047732
Rodriguez JA, Saadi A, Schwamm LH, Bates DW, Samal L. Disparities in telehealth use among California patients with limited English proficiency. Health Affairs. 2021;40(3):487-495.
doi: 10.1377/hlthaff.2020.00823
pubmed: 33646862
Rodriguez JA, Clark CR, Bates DW. Digital health equity as a necessity in the 21st Century Cures Act Era. JAMA. 2020;323(23):2381-2382.
doi: 10.1001/jama.2020.7858
pubmed: 32463421
Ray KN, Shi Z, Gidengil CA, Poon SJ, Uscher-Pines L, Mehrotra A. Antibiotic prescribing during pediatric direct-to-consumer telemedicine visits. Pediatrics. 2019;143(5):e20182491.
doi: 10.1542/peds.2018-2491
pubmed: 30962253
Ray KN, Martin JM, Wolfson D, et al. Antibiotic prescribing for acute respiratory tract infections during telemedicine visits within a pediatric primary care network. Acad Pediatr. 2021;21(7):1239-1243.
doi: 10.1016/j.acap.2021.03.008
pubmed: 33741531
Shi Z, Mehrotra A, Gidengil CA, Poon SJ, Uscher-Pines L, Ray KN. Quality of care for acute respiratory infections during direct-to-consumer telemedicine visits for adults. Health Affairs (Project Hope). 2018;37(12):2014-2023.
doi: 10.1377/hlthaff.2018.05091
pubmed: 30633682
pmcid: 6739118
Hamdy RF, Park D, Dean K, et al. Geographic variability of antibiotic prescribing for acute respiratory tract infections within a direct-to-consumer telemedicine practice. Infect Control Hosp Epidemiol. 2022;43(5):651-653.
Yao P, Clark S, Gogia K, Hafeez B, Hsu H, Greenwald P. Antibiotic prescribing practices: is there a difference between patients seen by telemedicine versus those seen in-person? Telemed J e-Health: the official journal of the American Telemedicine Association. 2020;26(1):107-109.
doi: 10.1089/tmj.2018.0250