Buchalter Daniel B., Moses Michael J., Azad Ali, Kirby David J., Huang Shengnan, Bosco Joseph A., Yang S. Steven
Bull Hosp Jt Dis (2013). 2020 Dec;78(4):227-235.
Until recently, telehealth represented a small fraction of orthopedic surgery patient interactions. The COVID-19 pandemic necessitated a swift adoption of telehealth to avoid patient and provider exposure. This study analyzed patient and surgeon satisfaction with telehealth within the department of orthopedic surgery during the height of the COVID-19 pandemic.
All orthopedic surgery patients who partici-pated in telehealth from March 30 to April 30, 2020, were sent a 14-question survey via e-mail. Orthopedic surgeons who used telehealth were sent a separate 14-question survey at the end of the study period. Factors influencing patient satisfaction were determined using univariate proportional odds and multivariate partial proportional odds models.
Three hundred and eighty-two patients and 33 surgeons completed the surveys. On average, patients were "satisfied" with telehealth (4.25/5.00 ± 0.96), and 37.0% preferred future visits to be conducted using telehealth. Multivariate partial proportional odds modeling determined that patients who found it easiest to arrange the telehealth visit had greater satisfaction (5.00/5.00 vs. 1.00-3.00/5.00: OR = 3.058; 95% CI = 1.621 to 5.768, p < 0.001), as did patients who believed they were able to communicate most effectively (5.00/5.00 vs. 1.00-4.00/5.00: OR = 20.268; 95% CI = 5.033 to 81.631, p < 0.001). Surgeons were similarly "satisfied" with telehealth (3.94/5.00 ± 0.86), and while their physical examinations were only "moderately effec-tive" (2.64/5.00 ± 0.99), they were "fairly confident" in their diagnoses (4.03/5.00 ± 0.64). Lastly, 36.7% ± 24.7% of surgeons believed that their telehealth patients required an in-person visit, and 93.9% of surgeons will continue using telehealth in the future.
Telehealth emerged as a valuable tool for the delivery of health care during the COVID-19 pandemic. While both patients and surgeons were satisfied with its use, this study identifies areas that can improve the patient and surgeon experience. The effectiveness and satisfaction with telehealth should inform regulatory and reimbursement policy.
直到最近,远程医疗在骨科手术患者互动中所占比例还很小。新冠疫情使得迅速采用远程医疗以避免患者和医护人员接触成为必要。本研究分析了在新冠疫情高峰期骨科手术科室中患者和外科医生对远程医疗的满意度。
2020年3月30日至4月30日参与远程医疗的所有骨科手术患者通过电子邮件收到一份包含14个问题的调查问卷。在研究期结束时,向使用远程医疗的骨科外科医生发送一份单独的包含14个问题的调查问卷。使用单变量比例优势模型和多变量部分比例优势模型确定影响患者满意度的因素。
382名患者和33名外科医生完成了调查。患者对远程医疗平均“满意”(4.25/5.00±0.96),37.0%的患者倾向于未来就诊采用远程医疗方式。多变量部分比例优势模型确定,认为安排远程医疗就诊最容易的患者满意度更高(5.00/5.00对比1.00 - 3.00/5.00:比值比 = 3.058;95%置信区间 = 1.621至5.768,p < 0.001),认为自己沟通最有效的患者也是如此(5.00/5.00对比1.00 - 4.00/5.00:比值比 = 20.268;95%置信区间 = 5.033至81.631,p < 0.001)。外科医生对远程医疗同样“满意”(3.94/5.00±0.86),虽然他们的体格检查效果仅为“中等”(2.64/5.00±0.99),但他们对自己的诊断“相当有信心”(4.03/5.00±0.64)。最后,36.7%±24.7%的外科医生认为他们的远程医疗患者需要进行面对面就诊,93.9%的外科医生未来将继续使用远程医疗。
在新冠疫情期间,远程医疗成为提供医疗服务的一项有价值的工具。虽然患者和外科医生都对其使用感到满意,但本研究确定了可以改善患者和外科医生体验的领域。远程医疗的有效性和满意度应作为监管和报销政策的参考依据。