Alexander Vinita M, Schelble Allison P, Omurtag Kenan R
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University, St. Louis, Missouri.
F S Rep. 2021 Apr 15;2(2):224-229. doi: 10.1016/j.xfre.2021.04.001. eCollection 2021 Jun.
To assess the differences in demographics, the likelihood of receiving treatment, and the clinical outcomes between new patients seen via telemedicine and those seen in person in an academic fertility practice.
Retrospective cohort study.
University-based fertility clinic.
All new patients seen via telemedicine between June 1, 2017, and February 29, 2020, were compared with an equal number of all new patients seen in person between May 1, 2019, and June 30, 2019.
None.
The primary outcome was receiving treatment after a new-patient visit. Binary logistic regression analyses were performed to estimate the odds ratio for not receiving treatment according to distance to the clinic and duration of infertility. The secondary outcomes included treatment recommendation, time to treatment initiation, and time to positive pregnancy test (if achieved). In addition we assessed patient demographics and visit traits per patient encounter.
The telemedicine and in-person groups each contained 70 patients. The following were similar between the groups: age, body mass index, Area Deprivation Index, diagnosis made at the new-patient visit, and the number of clinic contacts before starting treatment. Compared with patients who had in-person new-patient visits, those who had telemedicine new-patient visits lived farther from the clinic (mean, 223.6 vs. 69.28 miles) and had a longer duration of infertility (mean, 41.9 vs. 19.49 months). No differences were noted between the groups in the following outcomes: percent that received treatment, time to treatment initiation, or time to pregnancy. Telemedicine new-patient visits were shorter than in-person new-patient visits (mean, 56.3 ± 9.1 vs. 59.3 ± 4.6 minutes) and less likely to contain documentation of height or weight.
Telemedicine appears to be of particular interest to patients who live farther from clinics and have longer durations of infertility, and it could reduce visit times. New patients seen in person and those seen via telemedicine are equally likely to pursue treatment. Telemedicine consultation for new-patient visits is feasible in an academic fertility practice and may be especially useful during a pandemic and in non-pandemic times in areas with limited access to fertility specialists.
评估在一家学术性生育诊所中，通过远程医疗就诊的新患者与亲自就诊的新患者在人口统计学特征、接受治疗的可能性以及临床结局方面的差异。
回顾性队列研究。
大学附属生育诊所。
将2017年6月1日至2020年2月29日期间通过远程医疗就诊的所有新患者与2019年5月1日至2019年6月30日期间亲自就诊的同等数量的所有新患者进行比较。
无。
主要结局是新患者就诊后接受治疗的情况。进行二元逻辑回归分析以估计根据到诊所的距离和不孕持续时间未接受治疗的比值比。次要结局包括治疗建议、开始治疗的时间以及出现阳性妊娠试验的时间（如果成功怀孕）。此外，我们评估了每位患者每次就诊时的人口统计学特征和就诊特点。
远程医疗组和亲自就诊组各有70名患者。两组之间在以下方面相似：年龄、体重指数、地区贫困指数、新患者就诊时的诊断以及开始治疗前的诊所联系次数。与亲自进行新患者就诊的患者相比，通过远程医疗进行新患者就诊的患者居住距离诊所更远（平均距离分别为223.6英里和69.28英里）且不孕持续时间更长（平均分别为41.9个月和19.49个月）。两组在以下结局方面未发现差异：接受治疗的百分比、开始治疗的时间或怀孕时间。远程医疗新患者就诊时间比亲自就诊时间短（平均分别为56.3±9.1分钟和59.3±4.6分钟），且包含身高或体重记录的可能性较小。
远程医疗似乎对居住距离诊所较远且不孕持续时间较长的患者特别有吸引力，并且可以减少就诊时间。亲自就诊的新患者和通过远程医疗就诊的新患者接受治疗的可能性相同。在学术性生育诊所中，新患者远程医疗咨询是可行的，并且在大流行期间以及在获得生育专家服务机会有限的地区的非大流行时期可能特别有用。
