Melian Christina, Frampton Christopher, Wyatt Michael Charles, Kieser David
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States.
University of Otago, Christchurch, New Zealand.
JMIR Form Res. 2021 Jun 15;5(6):e28140. doi: 10.2196/28140.
The global adoption of teleconsultation has been expedited as a result of the COVID-19 pandemic. By allowing remote communication, teleconsultation may help limit the spread of the virus while maintaining the crucial patient-provider relationship.
The aim of this study is to evaluate the value of teleconsultation compared to in-person visits in the management of elective orthopedic and spinal procedures.
This was a prospective observational cohort study of 853 patients receiving orthopedic and spinal care at a private outpatient clinic in New Zealand. Patients were randomly divided into two groups: (1) patients receiving telephone consultation remotely, and (2) patients receiving in-person office consultations at the outpatient clinic. All patients received telephone consultations for 4 weeks during the mandated COVID-19 lockdown, followed by 4 weeks of telephone or in-person consultation. Patient preference, satisfaction, and duration of visit were recorded. Comparisons of patient preference between groups, visit type, sex, and location were performed using chi-square tests; similarly, satisfaction scores and visit durations were compared using a general linear model.
We report that 91% (353/388) of patients in the telephone group preferred teleconsultation over in-person office visits during the COVID-19 lockdown (P<.001). A combined-group analysis showed that 55.3% (446/807) of all patients preferred teleconsultation compared to 31.2% (252/807) who preferred in-person office visits (P<.001). Patients in the telephone group reported significantly higher satisfaction scores (mean 9.95, SD 0.04, 95% CI 9.87-10.03) compared to patients in the in-person group (mean 9.53, SE 0.04, 95% CI 9.45-9.62; P<.001). Additionally, in-person consultations were significantly longer in duration compared to telephone consultations, with a mean visit time of 6.70 (SE 0.18) minutes, 95% CI 6.32-7.02, compared to 5.10 (SE 0.17) minutes, 95% CI 4.73-5.42 (P<.001).
Patients who use telephone consultations are more likely to prefer it over traditional, in-person visits in the future. This increased preference, coupled with higher patient satisfaction scores and shorter duration of visits, suggests that teleconsultation has a role in orthopedic surgery, which may even extend beyond the COVID-19 pandemic.
由于新冠疫情，远程会诊在全球的应用得到了加速。通过实现远程通信，远程会诊有助于在维持关键的医患关系的同时限制病毒传播。
本研究旨在评估在择期骨科和脊柱手术管理中，与面对面就诊相比，远程会诊的价值。
这是一项对新西兰一家私立门诊接受骨科和脊柱护理的853例患者进行的前瞻性观察队列研究。患者被随机分为两组：（1）接受远程电话会诊的患者，（2）在门诊接受面对面办公室会诊的患者。在新冠疫情强制封锁期间，所有患者均接受了4周的电话会诊，随后是4周的电话或面对面会诊。记录患者的偏好、满意度和就诊时长。使用卡方检验对两组之间、就诊类型、性别和地点的患者偏好进行比较；同样，使用一般线性模型对满意度得分和就诊时长进行比较。
我们报告称，在新冠疫情封锁期间，电话组中91%（353/388）的患者更喜欢远程会诊而非面对面办公室就诊（P<0.001）。综合组分析显示，所有患者中有55.3%（446/807）更喜欢远程会诊，而更喜欢面对面办公室就诊的患者占31.2%（252/807）（P<0.001）。与面对面组的患者（平均9.53，标准误0.04，95%置信区间9.45 - 9.62；P<0.001）相比，电话组的患者报告的满意度得分显著更高（平均9.95，标准差0.04，95%置信区间9.87 - 10.03）。此外，面对面会诊的时长明显长于电话会诊，平均就诊时间为6.70（标准误0.18）分钟，95%置信区间6.32 - 7.02，而电话会诊为5.10（标准误0.17）分钟，95%置信区间4.73 - 5.42（P<0.001）。
使用电话会诊的患者未来更有可能比传统的面对面就诊更喜欢它。这种更高的偏好，再加上更高的患者满意度得分和更短的就诊时长，表明远程会诊在骨科手术中具有作用，甚至可能在新冠疫情之后仍能延续。
