耳鼻喉科 COVID-19 期间的远程医疗：患者和医生满意度。

Telemedicine in Otolaryngology During COVID-19: Patient and Physician Satisfaction.

机构信息

Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

出版信息

Otolaryngol Head Neck Surg. 2022 Jul;167(1):56-64. doi: 10.1177/01945998211041921. Epub 2021 Sep 7.

DOI:10.1177/01945998211041921

PMID:34491856

Abstract

OBJECTIVE

To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors.

STUDY DESIGN

Prospective cohort study.

SETTING

Tertiary care center.

METHODS

Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre-COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire.

RESULTS

The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, -0.5 to 2.1, excluding the noninferiority margin of -1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = -5.2 [95% CI, -6.6 to -3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores.

CONCLUSIONS

Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.

摘要

目的

在 COVID-19 期间检查耳鼻喉科远程医疗的患者和医生满意度，并确定相关因素。

研究设计

前瞻性队列研究。

设置

三级护理中心。

方法

对 2020 年 5 月至 7 月期间有就诊经历的患者（年龄≥18 岁，n=407）进行患者满意度评估。15 名耳鼻喉科医生对 2020 年 5 月至 6 月期间提供的特定就诊经历进行医生满意度评估（n=1011）。患者满意度通过盖洛普患者满意度问卷和远程医疗满意度问卷进行评估。对 COVID-19 期间远程医疗就诊的盖洛普平均满意度评分与 COVID-19 之前的面对面就诊的盖洛普评分（n=3059）进行比较，以检验非劣效性假设。医生满意度通过医生满意度问卷进行评估。

结果

远程医疗就诊的盖洛普患者满意度平均得分为 94.5（标准差，8.8），与 COVID-19 之前的面对面就诊的 93.7（标准差，15.5；Δ=0.8[95%CI，-0.5 至 2.1，排除非劣效性边界-1]）相差不大。与电话相比，视频会议（vs 电话）和报告较高收入的患者与较高的远程医疗满意度问卷评分相关。COVID-19 期间远程医疗就诊的医生满意度评分总体较高，为 83.3（95%CI，77.5-89.1），与面对面就诊的 88.4（95%CI，82.5-94.3）相比略低（Δ=-5.2[95%CI，-6.6 至-3.8]）。与电话相比，视频会议（vs 电话）和患者首选英语语言和随访就诊与较高的医生满意度问卷评分相关。