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远程医疗改善了肝病咨询的可及性,患者满意度高。

Telemedicine Improves Access to Hepatology Consultation with High Patient Satisfaction.

作者信息

Mauro Ezequiel, Marciano Sebastián, Torres María C, Roca Juan D, Novillo Abel L, Gadano Adrían

机构信息

Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina.

Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina.

出版信息

J Clin Exp Hepatol. 2020 Nov-Dec;10(6):555-562. doi: 10.1016/j.jceh.2020.04.017. Epub 2020 May 5.

Abstract

AIMS

Telemedicine between health care providers could be useful for improving the access to hepatology consultations, which is challenging in some regions. The primary objective of this study was to estimate the proportion of consultations that were resolved through a telemedicine program. Additionally, we evaluated patient satisfaction with this strategy.

METHODS

Consecutive telemedicine consultations made by non-hepatologist health care providers from different regions of Argentina to a specialty hepatology team were included. Participants and hepatologists used e-mail, teleconference systems, WhatsApp, or telephone to interact, depending on their preferences. Consultations were considered to be resolved through telemedicine when a diagnosis and an adequate follow-up were achieved without the need to refer the patient to a hepatologist or other specialist. Patient satisfaction with telemedicine was evaluated using the Patient Satisfaction Questionnaire Short Form and Telemedicine Satisfaction Questionnaire.

RESULTS

A total of 200 telemedicine consultations made by 24 physicians from 10 different provinces of Argentina were evaluated, of which 145 (73%; 95% CI: 66%-79%) were resolved through telemedicine. Practitioners specialities were as follows: family physicians, internists, gastroenterologists, infectious diseases, and obstetrics. The most frequent final diagnoses for those patients whose consultation was resolved through telemedicine were non-alcoholic fatty liver disease, viral hepatitis, and benign hepatic lesions. A high degree of patient satisfaction with telemedicine was observed in both questionnaires.

CONCLUSIONS

Our results show the effectiveness of telemedicine in hepatology, with high resolution rate of consultations and rapid access to experts' assessment. Additionally, a high degree of patient satisfaction was observed using prevalidated questionnaires.

摘要

目的

医疗服务提供者之间的远程医疗有助于改善肝病咨询的可及性,这在某些地区具有挑战性。本研究的主要目的是估计通过远程医疗计划解决的咨询比例。此外,我们评估了患者对该策略的满意度。

方法

纳入了来自阿根廷不同地区的非肝病专科医疗服务提供者向一个肝病专科团队进行的连续远程医疗咨询。参与者和肝病专家根据自己的偏好使用电子邮件、电话会议系统、WhatsApp或电话进行互动。当在无需将患者转诊给肝病专家或其他专科医生的情况下实现诊断和适当随访时,咨询被视为通过远程医疗解决。使用患者满意度问卷简表和远程医疗满意度问卷评估患者对远程医疗的满意度。

结果

共评估了来自阿根廷10个不同省份的24名医生进行的200次远程医疗咨询,其中145次(73%;95%CI:66%-79%)通过远程医疗解决。从业者的专业如下:家庭医生、内科医生、胃肠病学家、传染病专家和产科医生。通过远程医疗解决咨询的患者最常见的最终诊断是非酒精性脂肪性肝病、病毒性肝炎和良性肝病变。两份问卷均显示患者对远程医疗的满意度较高。

结论

我们的结果显示了远程医疗在肝病领域的有效性,咨询解决率高,且能快速获得专家评估。此外,使用经过预验证的问卷观察到患者满意度较高。

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