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远程医疗虚拟就诊在小儿脊柱畸形患者中的应用:大型学术中心的可行性与患者满意度比较

Utilization of Telemedicine Virtual Visits in Pediatric Spinal Deformity Patients: A Comparison of Feasibility and Patient Satisfaction at a Large Academic Center.

作者信息

Sultan Assem A, Acuña Alexander J, Samuel Linsen T, Rabin Jacob M, Grits Daniel, Gurd David P, Kuivila Thomas E, Goodwin Ryan C

机构信息

Department of Orthopaedic Surgery, Cleveland Clinic Foundation.

Cleveland Clinic Lerner College of Medicine, Cleveland, OH.

出版信息

J Pediatr Orthop. 2020 Sep;40(8):e712-e715. doi: 10.1097/BPO.0000000000001553.

Abstract

BACKGROUND

Telemedicine platforms have been developed to support the convenient delivery of health care services to their patients while maintaining appropriate quality of care. However, it is unclear whether they can be utilized effectively in patients with pediatric spinal deformity (PSD). Therefore, this study aimed to evaluate the feasibility and patient satisfaction associated with virtual visit (VV) utilization in PSD patients in comparison to general pediatric orthopaedic indications.

METHODS

Of the 482 VVs offered to pediatric orthopaedic patients at a large academic health care system between January 1, 2017, and December 31, 2018, a total of 189 VVs conducted by board-certified orthopaedic surgeons were included in the final analysis. Patient satisfaction scores were collected at the end of each VV by patient and parent rankings of the surgeon and the telemedicine service. Data on patients, visits, and connectivity sessions characteristics were collected and statistically compared between PSD visits (n=33) versus those conducted for general pediatric orthopaedic indications (n=156).

RESULTS

Although PSD patients were older (15±3.7 vs. 12±4.7 y; P<0.01), mostly female (76% vs. 47%, P=0.003), and had longer VVs (8±4.6 vs. 5±3.6 min; P=0.003) versus their general pediatric orthopaedic counterparts, they demonstrated similarly high satisfaction scores for surgeon performance (5±0 vs. 4.8±0.1 points; P=0.08) and overall satisfaction (3±2.4 vs. 3.5±2.1; P=0.23). Approximately 80% of all VVs were conducted over mobile devices. Wait time was substantially less for PSD VVs relative to subsequent office visits (13±10 vs. 41±30 min; P<0.001).

CONCLUSIONS

Our analysis found that telemedicine VVs provided a convenient alternative to traditional in-office visits for PSD patients. Specifically, we found that PSD patients received faster care with comparable satisfaction. The findings of our present analysis should encourage health care systems to continually evaluate and implement telehealth platforms to improve both the accessibility and appropriate quality of care.

LEVEL OF EVIDENCE

Level IV.

摘要

背景

远程医疗平台已被开发出来,以支持在保持适当医疗质量的同时,为患者提供便捷的医疗服务。然而,尚不清楚它们是否能有效地应用于小儿脊柱畸形(PSD)患者。因此,本研究旨在评估与虚拟就诊(VV)在PSD患者中的应用相关的可行性和患者满意度,并与一般小儿骨科适应症进行比较。

方法

在2017年1月1日至2018年12月31日期间,在一个大型学术医疗系统中为小儿骨科患者提供的482次VV中,共有189次由获得董事会认证的骨科外科医生进行的VV被纳入最终分析。在每次VV结束时,通过患者和家长对医生和远程医疗服务的排名来收集患者满意度评分。收集患者、就诊和连接会话特征的数据,并在PSD就诊(n=33)与一般小儿骨科适应症就诊(n=156)之间进行统计比较。

结果

尽管PSD患者年龄较大(15±3.7岁对12±4.7岁;P<0.01),大多为女性(76%对47%,P=0.003),且与一般小儿骨科患者相比,VV时间更长(8±4.6分钟对5±3.6分钟;P=0.003),但他们对医生表现的满意度评分(5±0分对4.8±0.1分;P=0.08)和总体满意度(3±2.4对3.5±2.1;P=0.23)同样很高。大约80%的VV是通过移动设备进行的。PSD患者的等待时间相对于后续门诊就诊明显更短(13±10分钟对41±30分钟;P<0.001)。

结论

我们的分析发现,远程医疗VV为PSD患者提供了一种方便的替代传统门诊就诊的方式。具体而言,我们发现PSD患者能更快地获得治疗,且满意度相当。我们目前分析的结果应鼓励医疗系统不断评估和实施远程医疗平台,以提高医疗服务的可及性和适当质量。

证据水平

四级。

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