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帕金森病中的远程医疗:三级医疗中心患者的视角

Telemedicine in Parkinson's disease: A patient perspective at a tertiary care centre.

作者信息

Qiang Judy K, Marras Connie

机构信息

Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.

Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Research, Division of Neurology, University of Toronto, 399 Bathurst St., Toronto, ON M5T 2S8, Canada.

出版信息

Parkinsonism Relat Disord. 2015 May;21(5):525-8. doi: 10.1016/j.parkreldis.2015.02.018. Epub 2015 Feb 28.

Abstract

INTRODUCTION

To overcome travel distance and lack of local expertise, telemedicine programs have been implemented and are still pilot programs in many jurisdictions. Patient perspectives remain poorly understood. In the largest study to date, we examined user satisfaction and predictors of patient choice to use telemedicine among Parkinson's Disease (PD) patients in the context of a well-developed telemedicine system. These data can help to optimize healthcare delivery by telemedicine.

METHODS

A patient satisfaction questionnaire was administered to current or previous users via telephone. Patients' cost savings were determined. The proportion of non-users interested in using telemedicine was quantified. Demographic and clinical characteristics of those who expressed interest in the program vs. those who did not were compared.

RESULTS

A total of 34 users and 103 non-users were recruited. Users reported an average cost reduction of $200 and 209 minutes of reduction in commute time (p < 0.01). While a majority (29/34 users) reported interest in continuing with telemedicine, inexperience of some telehealth nurses was a major source of patient dissatisfaction. Patients preferred a combination of telehealth and in-person visits. A majority of non-users (55/103, 53%) declared interest in telemedicine, but it had not been offered to them. A lower Hoehn and Yahr stage and a longer commute time were associated with patient interest in telemedicine.

CONCLUSIONS

Training of nurses is an important determinant of patient satisfaction. Clinicians should consider offering telehealth to all patients for whom it is medically appropriate, especially those who experience long travel times.

摘要

引言

为了克服路途遥远以及缺乏当地专业知识的问题,远程医疗项目已被实施,并且在许多司法管辖区仍处于试点阶段。患者的观点仍未得到充分理解。在迄今为止规模最大的一项研究中,我们在一个完善的远程医疗系统背景下,调查了帕金森病(PD)患者对使用远程医疗的满意度以及选择使用远程医疗的预测因素。这些数据有助于优化远程医疗的医疗服务提供。

方法

通过电话向当前或以前的用户发放患者满意度调查问卷。确定患者节省的费用。对有兴趣使用远程医疗的非用户比例进行量化。比较了对该项目表示感兴趣的人群与不感兴趣人群的人口统计学和临床特征。

结果

共招募了34名用户和103名非用户。用户报告平均成本降低了200美元,通勤时间减少了209分钟(p<0.01)。虽然大多数(29/34名用户)表示有兴趣继续使用远程医疗,但一些远程健康护士缺乏经验是患者不满的主要来源。患者更喜欢远程健康和面对面就诊相结合的方式。大多数非用户(55/103,53%)表示对远程医疗感兴趣,但他们尚未获得相关服务。较低的Hoehn和Yahr分期以及较长的通勤时间与患者对远程医疗的兴趣相关。

结论

护士培训是患者满意度的重要决定因素。临床医生应考虑为所有在医学上合适的患者提供远程健康服务,尤其是那些路途时间长的患者。

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