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澳大利亚 COVID-19 大流行期间,专科门诊的远程医疗服务的患者满意度和可接受性。

Patient satisfaction and acceptability with telehealth at specialist medical outpatient clinics during the COVID-19 pandemic in Australia.

机构信息

Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

出版信息

Intern Med J. 2021 Jul;51(7):1028-1037. doi: 10.1111/imj.15205. Epub 2021 Jul 2.

Abstract

BACKGROUND

Outpatient clinics were shifted rapidly to telehealth in Australia during the Coronavirus disease 19 (COVID-19) pandemic, drastically altering patient care and experience.

AIMS

To investigate patient satisfaction and acceptability of telehealth consultations during the COVID-19 pandemic.

METHODS

Prospective observation study conducted in two hospital rheumatology outpatient departments (OPD) undertaking telehealth consultations during COVID-19. A modified version of a validated telehealth evaluation survey was posted to all patients attending the telehealth OPD rheumatology clinics, including balanced 5-point Likert scales and free-text responses. Cluster analysis was applied to the Likert-scale questions, alongside thematic analysis of free-text responses.

RESULTS

There were 128 respondents (29% response rate), of which 69.5% were women and the majority (87.5%) was aged 50 years or older. All telehealth consultations were conducted by telephone. Nearly one-fifth of patients indicated consistent dissatisfaction with telehealth across the range of questions. These patients were older, reported lower educational qualifications and lower health literacy scores and lacked access to the Internet. While many patients found this mode of consultation to be convenient, patients expressed concerns regarding absence of physical examination. A recurrent theme was a desire for a mixed-model clinic in the future, with flexibility of having both telehealth and face-to-face consultations.

CONCLUSIONS

This study offers unique insights into patients' experiences with telehealth, which until the current global pandemic, has been an uncommon mode of consultation delivery in urban areas. This study suggests when defining the place of telehealth in future healthcare delivery, patient perspective and careful patient selection will be key. Disease progression, language and cognitive ability, health literacy, technology access and patient and clinician preference are important considerations when deciding how effectively to embed and integrate telehealth into consultations.

摘要

背景

在 2019 冠状病毒病(COVID-19)大流行期间,澳大利亚的门诊迅速转向远程医疗,这极大地改变了患者的护理和体验。

目的

调查 COVID-19 期间远程医疗咨询的患者满意度和可接受性。

方法

在两家医院风湿病门诊(OPD)进行前瞻性观察研究,这些门诊在 COVID-19 期间开展远程医疗咨询。向所有参加远程医疗 OPD 风湿病诊所的患者发送了经过修改的经过验证的远程医疗评估调查的版本,其中包括平衡的 5 分李克特量表和自由文本回复。对李克特量表问题应用聚类分析,同时对自由文本回复进行主题分析。

结果

共有 128 名患者(29%的回复率)做出了回应,其中 69.5%为女性,大多数(87.5%)年龄在 50 岁或以上。所有远程医疗咨询均通过电话进行。近五分之一的患者在一系列问题上表示对远程医疗始终不满意。这些患者年龄较大,报告的教育程度较低,健康素养得分较低,并且无法访问互联网。虽然许多患者认为这种咨询模式很方便,但他们对缺乏体检表示担忧。一个反复出现的主题是对未来混合模式诊所的渴望,这种诊所将来具有灵活性,可以同时进行远程医疗和面对面咨询。

结论

这项研究提供了有关患者远程医疗体验的独特见解,直到当前的全球大流行之前,远程医疗在城市地区一直是一种不常见的咨询提供方式。这项研究表明,在定义远程医疗在未来医疗保健中的地位时,患者观点和仔细的患者选择将是关键。疾病进展、语言和认知能力、健康素养、技术访问以及患者和临床医生的偏好是在决定如何有效地将远程医疗嵌入和整合到咨询中时需要考虑的重要因素。

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