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辅助生殖技术可及性的地区差异:利用现代技术缩小差距时评估患者满意度。

Regional disparities in access to assisted reproductive technology: assessment of patient satisfaction when employing modern technology to close the gap.

机构信息

Department of Obstetrics & Gynecology, Section of Reproductive Endocrinology Infertility and Genetics, Augusta University, 1120 15th Street, BB-7518, Augusta, GA, 30912, USA.

出版信息

J Assist Reprod Genet. 2021 Apr;38(4):889-894. doi: 10.1007/s10815-020-02027-7. Epub 2021 Jan 14.

Abstract

PURPOSE

Geographic disparities for assisted reproductive technology (ART) continue to exist. Travel cost and time off work may create additional barriers for patients living remotely. Implementing telehealth can alleviate these barriers by reducing office visits. The aim of this study was to evaluate patient satisfaction with telehealth during ART.

METHODS

This was a cross-sectional survey and retrospective cohort study. Patients living remotely who underwent ART utilizing telehealth between 2015 and 2018 at a single institution were selected for the telehealth group. The non-telehealth control group included randomly selected patients who underwent IVF at the same institution between 2015 and 2018. Demographic variables and treatment outcomes were obtained for both groups. A patient satisfaction questionnaire was distributed to telehealth patients. Statistical analysis using χ test was performed to compare ART outcomes between both groups.

RESULTS

Ninety-seven control and 97 telehealth patients were included. For telehealth patients, the mean number of office visits and distance traveled was 2.9 (± 0.8 SD) and 143.1 miles (± 49.2 SD) respectively. 58.8% of patients completed the survey. 44/57 participants had an oocyte retrieval and 42/44 underwent embryo transfer. For those who completed the survey, the clinical pregnancy rate was 31/44 and the live birth rate was 25/44. There was no difference in treatment outcomes between telehealth compared to controls. 73% of patients were highly satisfied with telehealth.

CONCLUSIONS

Telehealth can improve access to ART in underserved areas and results in high patient satisfaction. Reproductive health providers could consider telehealth as a safe and efficacious tool to ameliorate geographic disparities.

摘要

目的

辅助生殖技术(ART)的地域差异仍然存在。对于居住在偏远地区的患者来说,旅行成本和请假可能会带来额外的障碍。实施远程医疗可以通过减少就诊次数来缓解这些障碍。本研究旨在评估接受 ART 治疗的患者对远程医疗的满意度。

方法

这是一项横断面调查和回顾性队列研究。选择 2015 年至 2018 年期间在一家机构接受远程医疗辅助生殖技术治疗的远程居住患者作为远程医疗组。非远程医疗对照组包括 2015 年至 2018 年期间在同一机构接受 IVF 的随机选择的患者。收集两组患者的人口统计学变量和治疗结局。向远程医疗患者发放患者满意度问卷。使用 χ 检验对两组的 ART 结局进行统计学分析。

结果

纳入了 97 例对照组和 97 例远程医疗组患者。对于远程医疗患者,就诊次数的平均值为 2.9(±0.8 SD),行驶距离为 143.1 英里(±49.2 SD)。58.8%的患者完成了调查。44/57 名患者进行了卵母细胞采集,42/44 名患者进行了胚胎移植。在完成调查的患者中,临床妊娠率为 31/44,活产率为 25/44。与对照组相比,远程医疗组的治疗结局没有差异。73%的患者对远程医疗非常满意。

结论

远程医疗可以改善服务不足地区获得 ART 的机会,并获得患者的高度满意度。生殖健康提供者可以考虑将远程医疗作为一种安全有效的工具,以改善地域差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f266/8079589/21c8a622e7ba/10815_2020_2027_Fig1_HTML.jpg

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