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对农村风湿病远程医疗服务的满意度。

Satisfaction with rural rheumatology telemedicine service.

作者信息

Poulsen Katherine A, Millen Catherine M, Lakshman Umayal I, Buttner Petra G, Roberts Lynden J

机构信息

The Townsville Hospital, Townsville, Queensland, Australia.

出版信息

Int J Rheum Dis. 2015 Mar;18(3):304-14. doi: 10.1111/1756-185X.12491. Epub 2014 Dec 20.

Abstract

AIM

To assess patient satisfaction with the rheumatology telemedicine service provided to a rural town in northern Australia.

METHODS

A prospective, questionnaire-based exploratory study of patients seen at the Mount Isa (rural town) rheumatology telemedicine clinics during 2012 was undertaken. Control groups included patients travelling over 3 h to be seen face-to-face in Townsville (tertiary referral centre), and patients seen at the infrequent face-to-face clinic in Mount Isa. A 5-point Likert scale was used to explore themes of communication, confidentiality, physical examination, rapport, medication safety and access.

RESULTS

This study evaluated 107 rheumatology outpatients (49 telemedicine, 46 face-to-face Townsville, 12 face-to-face Mount Isa). Patients seen in Mount Isa travelled a median of < 10 km for either the telemedicine or local face-to-face appointments. The patients attending the Townsville face-to-face clinic travelled a median of 354 km. New patients comprised 14% of consultations. Satisfaction with themes related to quality-of-care was high with over 90% selecting 'agree' or 'strongly agree' to these questions. Comparing models of care, there were no statistically significant differences in the rates of those selecting 'strongly agree' across questions, apart from a single question related to rapport which favored the Mount Isa face-to-face model (P = 0.018). When asked whether they would rather travel to Townsville than participate in a telemedicine consultation, 63% of patients selected 'disagree' (17%) or 'strongly disagree' (46%).

CONCLUSIONS

These results suggest that patients are satisfied with a rheumatology telemedicine service, and may prefer this to extensive travelling. Evaluation in other settings is recommended before generalizing this finding.

摘要

目的

评估澳大利亚北部一个乡村小镇的患者对所提供的风湿病远程医疗服务的满意度。

方法

对2012年在芒特艾萨(乡村小镇)风湿病远程医疗诊所就诊的患者进行了一项基于问卷的前瞻性探索性研究。对照组包括前往汤斯维尔(三级转诊中心)进行面对面就诊需花费3个多小时的患者,以及在芒特艾萨不常见的面对面诊所就诊的患者。采用5点李克特量表来探究沟通、保密、体格检查、融洽关系、用药安全和就医便利性等主题。

结果

本研究评估了107名风湿病门诊患者(49名通过远程医疗就诊、46名在汤斯维尔进行面对面就诊、12名在芒特艾萨进行面对面就诊)。在芒特艾萨就诊的患者,无论是通过远程医疗还是当地面对面预约,出行距离中位数均小于10公里。前往汤斯维尔进行面对面就诊的患者出行距离中位数为354公里。新患者占会诊患者的14%。对与医疗质量相关主题的满意度较高,超过90%的患者对这些问题选择“同意”或“强烈同意”。比较不同的医疗模式,除了一个与融洽关系相关的问题(该问题支持芒特艾萨面对面模式,P = 0.018)外,各问题中选择“强烈同意”的比例在统计学上无显著差异。当被问及他们是否宁愿前往汤斯维尔也不愿参加远程医疗会诊时,63%的患者选择“不同意”(17%)或“强烈不同意”(46%)。

结论

这些结果表明患者对风湿病远程医疗服务感到满意,并且可能更倾向于这种方式而非长途奔波。在推广这一发现之前,建议在其他环境中进行评估。

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