Sankaran Janani, Menachery Sherin M, Bradshaw Robert D
From the Primary Medicine Department, San Joaquin General Hospital, French Camp, CA (JS), Eastern Virginia Medical School, Norfolk, VA (SMM), Department of Family and Community Medicine, EVMS, Norfolk, VA (RDB).
J Am Board Fam Med. 2020 Sep-Oct;33(5):765-773. doi: 10.3122/jabfm.2020.05.190362.
To understand patient attitudes, access toward video calling to enhance efficiency of after-hours triage calls.
We surveyed patients aged 18 to 89 years. Questions included demographics, preferences, access to video calling devices, and perceived advantages and disadvantages of this technology. Answers were entered into Qualtrics database and analyzed using JMP 11 (SAS, Cary, NC).
Two hundred ninety-eight patients agreed to participate. Mean age was 47.9 years; 71.6% were female; and 75.1% had access to video calling device. Device proficiency was inversely related to age and greatest in 18-to-32-years group (χ = 71.18, < .0001). Seventy-one percent of patients enjoyed video communication, directly proportional to education (trend test Z = 2.78, < .005). Adjusted for both age and education, respondents with college education or above were 3 times more likely to self identify as "good' with video (OR, 3.11; 95% CI, 1.48-6.64); those under age 48 had even higher proficiency (Odds ratio (OR), 13.9; 95% CI, 4.79-59.34). Patients with prior video experience were 3 times more likely to prefer video calling (Relative risk (RR) = 3.46; 95% CI, 1.95-6.11). Patients calling their doctor 5 or more times annually preferred video calling significantly more than calling by telephone (RR, 1.61; 95% CI, 1.31-1.97). Faster contact with the primary care provider (19.8%) was the most perceived advantage. Loss of in-person interaction with doctor (37.1%) was the greatest perceived disadvantage.
Patients seem to have access and interest in video communication for after-hours calls. Further studies are needed to evaluate whether addition of video component to after-hours triage calls will help reduce unnecessary emergency department visits.
了解患者对视频通话的态度、使用情况，以提高非工作时间分诊电话的效率。
我们对18至89岁的患者进行了调查。问题包括人口统计学信息、偏好、视频通话设备的使用情况，以及对该技术的优缺点的看法。答案录入Qualtrics数据库，并使用JMP 11（SAS，北卡罗来纳州卡里）进行分析。
298名患者同意参与。平均年龄为47.9岁；71.6%为女性；75.1%可使用视频通话设备。设备熟练程度与年龄呈负相关，在18至32岁组中最高（χ = 71.18，P <.0001）。71%的患者喜欢视频沟通，这与受教育程度成正比（趋势检验Z = 2.78，P <.005）。在对年龄和教育程度进行调整后，受过大学及以上教育的受访者自我认定对视频“熟练”的可能性是其他人的3倍（比值比（OR），3.11；95%置信区间，1.48 - ６.64）；48岁以下的人熟练程度更高（比值比（OR），13.9；95%置信区间，4.79 - 59.34）。有过视频使用经验的患者选择视频通话的可能性是其他人的3倍（相对风险（RR） = 3.46；95%置信区间，1.95 - 6.11）。每年给医生打电话5次或更多次的患者明显更倾向于视频通话而非电话通话（RR，1.61；95%置信区间，1.31 - 1.97）。与初级保健提供者更快取得联系（19.8%）是最常被提及的优势。与医生面对面交流的缺失（37.1%）是最常被提及的劣势。
患者似乎可以使用视频通话设备，并且对非工作时间的视频通话感兴趣。需要进一步研究来评估在非工作时间分诊电话中增加视频组件是否有助于减少不必要的急诊就诊。
