Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
JMIR Mhealth Uhealth. 2019 Jun 8;7(6):e13772. doi: 10.2196/13772.
The solution to the growing problem of rural residents lacking health care access may be found in the use of telemedicine and mobile health (mHealth). Using mHealth or telemedicine allows patients from rural or remote areas to have better access to health care.
The objective of this study was to understand factors influencing the choice of communication medium for receiving care, through the analysis of mHealth versus telemedicine encounters with a virtual urgent clinic.
We conducted a postdeployment evaluation of a new virtual health care service, Virtual Urgent Clinic, which uses mHealth and telemedicine modalities to provide patient care. We used a multinomial logistic model to test the significance and predictive power of a set of features in determining patients' preferred method of telecare encounters-a nominal outcome variable of two levels (mHealth and telemedicine).
Postdeployment, 1403 encounters were recorded, of which 1228 (87.53%) were completed with mHealth and 175 (12.47%) were telemedicine encounters. Patients' sex (P=.004) and setting (P<.001) were the most predictive determinants of their preferred method of telecare delivery, with significantly small P values of less than .01. Pearson chi-square test returned a strong indication of dependency between chief concern and encounter mediums, with an extremely small P<.001. Of the 169 mHealth patients who responded to the survey, 154 (91.1%) were satisfied by their encounter, compared with 31 of 35 (89%) telemedicine patients.
We studied factors influencing patients' choice of communication medium, either mHealth or telemedicine, for a virtual care clinic. Sex and geographic location, as well as their chief concern, were strong predictors of patients' choice of communication medium for their urgent care needs. This study suggests providing the option of mHealth or telemedicine to patients, and suggesting which medium would be a better fit for the patient based on their characteristics.
解决农村居民缺乏医疗保健机会的日益严重的问题的方法可能在于使用远程医疗和移动医疗（mHealth）。使用 mHealth 或远程医疗可以使农村或偏远地区的患者更好地获得医疗保健。
本研究旨在通过分析虚拟紧急诊所中的 mHealth 与远程医疗就诊，了解影响选择沟通媒介以获取护理的因素。
我们对一种新的虚拟医疗服务进行了部署后评估，该服务使用 mHealth 和远程医疗模式为患者提供护理。我们使用多项逻辑回归模型来测试一组功能对确定患者首选远程医疗就诊方式的重要性和预测能力，这是一个二分类的名义结果变量（mHealth 和远程医疗）。
部署后共记录了 1403 次就诊，其中 1228 次（87.53%）通过 mHealth 完成，175 次（12.47%）为远程医疗就诊。患者的性别（P=.004）和就诊地点（P<.001）是决定其首选远程医疗服务方式的最具预测性的决定因素，P 值均小于 0.01。Pearson 卡方检验强烈表明主要关注点和就诊媒介之间存在依赖性，P 值极小，小于 0.001。在 169 名接受调查的 mHealth 患者中，有 154 名（91.1%）对就诊感到满意，而 35 名远程医疗患者中只有 31 名（89%）感到满意。
我们研究了影响患者选择虚拟护理诊所的沟通媒介（mHealth 或远程医疗）的因素。性别和地理位置以及他们的主要关注点是患者选择紧急护理沟通媒介的有力预测因素。本研究建议为患者提供 mHealth 或远程医疗的选择，并根据患者的特点建议哪种媒介更适合患者。
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