College of Medicine, The Pennsylvania State University, State College, PA, USA -
Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA -
J Neurosurg Sci. 2023 Jun;67(3):351-354. doi: 10.23736/S0390-5616.20.05220-0. Epub 2021 Jan 4.
Coronavirus disease 2019 (COVID-19) has greatly disturbed healthcare and the practice of neurosurgery. As healthcare systems evolve in the face of COVID-19, the use of telehealth platforms has expanded. We presented the results of a large survey of patient perspectives on the role of telehealth in the care of spine clinic patients.
All patients at the spine clinic of a large, tertiary, academic medical center were surveyed at their clinic visit from May 30, 2020-June 30, 2020. All responses were anonymous, and results were analyzed with standard statistical techniques.
One hundred and seventy-six surveys were returned and 164 were entirely completed. 56.8% of patients were new while 24.4% were postoperative follow-up visits: 54.9% had lumbar symptoms. 85% had pain while more than half also reported weakness; 58% traveled greater than twenty-five miles for their appointment; 96% had transportation readily available. Of all respondents, only 15.3% preferred the appointment via video telehealth while 4% had no preference between in-person appointment or virtual visit. Preference for telehealth appointment was not associated with factors such as new or established in the practice, spinal region of symptoms, pain, weakness, comfort with technology, age, or duration of symptoms. There was a significant difference between how far the patient traveled for the clinic appointment and their preference for a telehealth appointment, with patients traveling further distances favoring telehealth (P=0.04). This effect remained significant when stratifying based on 25 miles (P=0.03) or 50 miles (P=0.03) but not when stratifying based on 100 miles (P=0.32). However, the sample size of patients traveling >100 miles was small, limiting any inference regarding that subgroup. Access to transportation was associated with preference for telehealth (88.89% vs. 97.18%, P=0.08) but did not reach statistical significance.
Most spine patients prefer in-person clinic appointments to virtual appointments. These preferences should be considered when arranging patient encounters.
2019 年冠状病毒病（COVID-19）极大地扰乱了医疗保健和神经外科的实践。随着医疗保健系统在 COVID-19 面前的发展，远程医疗平台的使用得到了扩展。我们展示了一项针对脊柱诊所患者对远程医疗在护理中作用的大型患者观点调查的结果。
从 2020 年 5 月 30 日至 2020 年 6 月 30 日，对一家大型三级学术医疗中心的脊柱诊所的所有患者进行了调查。所有回复均为匿名，结果采用标准统计技术进行分析。
共收回 176 份调查问卷，其中 164 份完整填写。56.8%的患者是新患者，24.4%是术后随访：54.9%有腰痛症状。85%有疼痛，超过一半的人还报告有无力感；58%的人去看诊的路程超过 25 英里；96%有交通工具。在所有受访者中，只有 15.3%更喜欢视频远程医疗预约，而 4%对面对面预约或虚拟就诊没有偏好。对远程医疗预约的偏好与在实践中的新老患者、症状的脊柱区域、疼痛、无力感、对技术的舒适度、年龄或症状持续时间等因素无关。患者去诊所就诊的路程与他们对远程医疗预约的偏好之间存在显著差异，去诊路程较远的患者更倾向于远程医疗（P=0.04）。当基于 25 英里（P=0.03）或 50 英里（P=0.03）进行分层时，这种效应仍然显著，但当基于 100 英里进行分层时（P=0.32）则不显著。然而，去诊路程超过 100 英里的患者样本量较小，限制了对该亚组的任何推断。获得交通工具的机会与远程医疗偏好相关（88.89%比 97.18%，P=0.08），但未达到统计学意义。
大多数脊柱患者更喜欢亲自到诊所就诊，而不是虚拟就诊。在安排患者就诊时应考虑这些偏好。
