Division of Otolaryngology, School of Medicine, Yale University, New Haven, Connecticut, USA.
Otolaryngol Head Neck Surg. 2020 Jul;163(1):138-144. doi: 10.1177/0194599820928987. Epub 2020 May 12.
Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care.
Retrospective review.
Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine.
Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized.
Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19-affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists ( < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, = .003).
A major decrease in the completion rates of scheduled visits was seen in the COVID-19-affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19-related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.
2019 年冠状病毒病(COVID-19)优先考虑了急性护理和远程医疗,这影响了就诊患者的数量及其护理方式。
回顾性研究。
在耶鲁大学医学院耳鼻喉科分部进行的单机构研究。
从 2020 年 3 月 16 日至 4 月 10 日,从耳鼻喉科分部的计费和预约行政记录中获取了所有门诊预约的数据。为了比较,还利用了 2019 年同期的相应时间段的数据。
在 5913 次预约中,有 3665 次(62.0%)在 2019 年 3 月 18 日至 4 月 12 日期间就诊,而在 COVID-19 相关时期就诊的次数为 649 次(12.9%)。在第 1 周和第 2 周完成的大多数就诊都是亲自就诊,而在第 3 周和第 4 周完成的大多数就诊都是通过远程医疗进行的。在各亚专业中,与普通/专业耳鼻喉科医生相比,2020 年完成就诊的儿科和头颈肿瘤科耳鼻喉科医生比例更高(<0.001)。与年轻成年人(18-64 岁)相比,老年成年人(≥65 岁)进行远程医疗就诊的可能性较小(45.6%比 59.6%,<0.001)。
在 COVID-19 相关时期,预约就诊的完成率大幅下降,但在各亚专业中不成比例。观察到远程医疗就诊的相应增加。在 COVID-19 相关医院政策改变后,大约 2 周后,远程医疗就诊超过了亲自就诊,但对于老年成年人而言并非如此。