Department of Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas, U.S.A.
Laryngoscope. 2020 Nov;130(11):2568-2573. doi: 10.1002/lary.29030. Epub 2020 Aug 31.
OBJECTIVES/HYPOTHESIS: The COVID-19 pandemic has led to unprecedented global changes in the delivery of healthcare over a short period of time. With the implementation of shelter-in-place orders, otolaryngology clinic visits at our institution were transitioned to telemedicine. This change enabled the rapid characterization of the patients who accepted and declined telemedicine.
Cross-sectional analysis.
A review was conducted of 525 otolaryngology patients at a tertiary-care referral center with scheduled visits requiring rescheduling to a future date or a telemedicine visit. Visit, demographic information, and reason for deferring telemedicine were collected for analysis.
Seventy-two percent of patients declined a telemedicine visit, with the most common reason being the lack of a physical exam (97%). There was an even distribution of demographics between those who accepted and declined visits. There was an association between declining telemedicine with older age (P = .0004) and otology visits (P = .0003), whereas facial plastics patients were more likely to accept (P < .0001). Patients scheduled earlier during the pandemic were more likely to accept a visit with a median of 28 days from onset of shelter-in-place orders versus 35 for those who declined (P < .0001).
We describe our initial experience with a transition to telemedicine, where the majority of patients would decline a virtual visit due to the lack of a physical exam. Although the future remains uncertain, telemedicine will continue to play a vital role in healthcare delivery. We believe that understanding our patient base gives critical insights that will help guide and improve virtual care to meet patients' needs.
4 Laryngoscope, 130:2568-2573, 2020.
目的/假设：新冠疫情在短时间内导致全球医疗保健服务发生了前所未有的变化。随着就地避难令的实施，我们机构的耳鼻喉科门诊就诊改为远程医疗。这种转变使我们能够快速了解接受和拒绝远程医疗的患者特征。
横断面分析。
对一家三级转诊中心的 525 名耳鼻喉科患者进行了回顾性分析，这些患者的预约需要改期或进行远程医疗。收集了就诊、人口统计学信息和推迟远程医疗的原因进行分析。
72%的患者拒绝了远程医疗，最常见的原因是缺乏体格检查（97%）。接受和拒绝就诊的患者在人口统计学方面分布均匀。拒绝远程医疗与年龄较大（P=0.0004）和耳科就诊（P=0.0003）之间存在关联，而面部整形患者更有可能接受（P<0.0001）。在疫情期间预约较早的患者更有可能接受就诊，中位数距离就地避难令开始时间为 28 天，而拒绝就诊的中位数为 35 天（P<0.0001）。
我们描述了向远程医疗过渡的初步经验，大多数患者由于缺乏体格检查而拒绝虚拟就诊。尽管未来仍不确定，但远程医疗将继续在医疗保健服务中发挥重要作用。我们认为，了解我们的患者群体可以提供关键的见解，这将有助于指导和改进虚拟护理，以满足患者的需求。
4.《喉镜》，130:2568-2573，2020.
