Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada.
Faculty of Medicine, University of Ottawa, Ontario, Canada.
Can J Diabetes. 2015 Aug;39(4):325-9. doi: 10.1016/j.jcjd.2014.12.010. Epub 2015 Mar 19.
The goal of this study was to establish patients' perspectives on the acceptability of wait times, the impact of wait times on their health and the possibility of using electronic consultations (eConsultations) to avoid visits to specialists. A 2-stage patient survey (self-administered and with a follow-up telephone call) and a chart audit was conducted on a sequential sample of patients attending their initial consultations in a tertiary diabetes and endocrinology centre. Patients' perspectives on actual and ideal wait times, the impact of waiting for access, the effectiveness of the referral-consultation process and attitudes toward eConsultations as an alternative to traditional referral-consultations were collected. The study involved 101 patients (22% for diabetes, 78% for endocrinologic conditions), whose comments were collated and categorized. Of the 101 patients who completed the survey, 61 also completed telephone interviews. The average wait time was 19 weeks; the median 10 weeks. More than 30% of patients waited longer than 6 months and 6% waited longer than 1 year. Overall, 90% of patients thought that the maximum wait time should be less than 3 months. While waiting, 58% of patients worried about a serious undiagnosed disease, 30% found their symptoms had affected their daily activities and 24% had to miss work or school due to symptoms. Of the patients, 46% considered eConsultation a viable alternative to face-to-face visits. Excessive wait times for specialist care remain barriers and have negative impacts on patients. Wait times significantly exceeded times patients considered acceptable. eConsultations provide acceptable alternatives for many patients, and they reduced the number of patients requiring traditional consultations.
本研究旨在了解患者对就诊等候时间的可接受性、等候时间对其健康的影响，以及使用电子咨询（eConsultation）来避免专科就诊的看法。我们对在一家三级糖尿病和内分泌中心初次就诊的连续患者样本进行了两阶段患者调查（自我管理和后续电话访问）和图表审核。收集了患者对实际和理想等候时间、等待就诊的影响、转诊咨询流程的有效性以及对电子咨询作为传统转诊咨询替代方案的态度等方面的看法。本研究涉及 101 名患者（22%为糖尿病患者，78%为内分泌疾病患者），对他们的意见进行了整理和分类。在完成调查的 101 名患者中，有 61 名还完成了电话访谈。平均等候时间为 19 周；中位数为 10 周。超过 30%的患者等候时间超过 6 个月，6%的患者等候时间超过 1 年。总的来说，90%的患者认为最长等候时间应少于 3 个月。在等候期间，58%的患者担心有严重的未确诊疾病，30%的患者发现他们的症状影响了他们的日常活动，24%的患者因症状而不得不请假或休学。在这些患者中，46%认为电子咨询是面对面就诊的可行替代方案。专科就诊的等候时间过长仍然是障碍，对患者产生负面影响。等候时间明显超过了患者认为可接受的时间。电子咨询为许多患者提供了可接受的替代方案，并减少了需要传统咨询的患者数量。
