Department of Urology, Michigan Medicine, Ann Arbor, MI.
University of Michigan Medical School, Ann Arbor, MI.
Urology. 2020 Oct;144:46-51. doi: 10.1016/j.urology.2020.05.080. Epub 2020 Jun 30.
To evaluate whether video visits were being used as substitutes to clinic visits prior to COVID-19 at our institution's outpatient urology centers.
We reviewed 600 established patient video visits completed by 13 urology providers at a tertiary academic center in southeast Michigan. We compared these visits to a random, stratified sample of established patient clinic visits. We assessed baseline demographics and visit characteristics for both groups. We defined our primary outcome ("revisit rate") as the proportion of additional healthcare evaluation (ie, office, emergency room, hospitalization) by a urology provider within 30 days of the initial encounter.
Patients seen by video visit tended to be younger (51 vs 61 years, P <.001), would have to travel further for a clinic appointment (82 vs 68 miles, P <.001), and were more likely to be female (36 vs 28%, P = .001). The most common diagnostic groups evaluated through video visits were nephrolithiasis (40%), oncology (18%) and andrology (14.3%). While the 30-day revisit rates were higher for clinic visits (4.3% vs 7.5%, P = .01) primarily due to previously scheduled appointments, revisits due to medical concerns were similar across both groups (0.5% vs 0.67%; P = .60).
Video visits can be used to deliver care across a broad range of urologic diagnoses and can serve as a substitute for clinic visits.
评估在我们机构的门诊泌尿科中心,COVID-19 之前视频就诊是否已被用作替代门诊就诊。
我们回顾了在密歇根州东南部的一家三级学术中心由 13 名泌尿科医生完成的 600 例已建立的患者视频就诊。我们将这些就诊与已建立的患者门诊就诊的随机分层样本进行了比较。我们评估了两组的基线人口统计学和就诊特征。我们将主要结局(“复诊率”)定义为在初次就诊后 30 天内由泌尿科医生进行额外医疗评估(即门诊、急诊、住院)的比例。
通过视频就诊的患者往往更年轻(51 岁 vs 61 岁,P <.001),需要更远距离前往诊所就诊(82 英里 vs 68 英里,P <.001),且更可能为女性(36% vs 28%,P = .001)。通过视频就诊评估的最常见诊断类别为肾结石(40%)、肿瘤学(18%)和男科(14.3%)。虽然门诊就诊的 30 天复诊率更高(4.3% vs 7.5%,P = .01),主要是因为已预约的就诊,但两组的因医疗问题而复诊的比例相似(0.5% vs 0.67%;P = .60)。
视频就诊可用于提供广泛的泌尿科诊断服务,可作为门诊就诊的替代方式。