Dholakia J, Kim J, Liang M I, Arend R C, Bevis K S, Straughn J M, Leath C A, Huh W K, Smith H J
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Gynecol Oncol Rep. 2021 Oct 1;38:100871. doi: 10.1016/j.gore.2021.100871. eCollection 2021 Nov.
To assess telemedicine readiness of gynecologic oncology patients, particularly those at risk for care access disparities (increased distance to care, rural populations.).
Patients at all disease/treatment stages completed an anonymous survey during in-person outpatient appointments at an academic comprehensive cancer center from 1/6/2020 to 2/28/2020, conducted prior to the COVID-19 pandemic, before the introduction of telemedicine in this practice.
Of 180 patients approached, 170 completed the survey (94.4%). Mean age was 59.6 years; 73.4% identified as White, 23.7% Black, and 2.9% other race. Ovarian cancer was most common (41.2%), followed by endometrial (27.1%), cervical (20.6%), and vaginal/vulvar (7.1%). Most patients traveled > 50 miles for appointments (63.8%); they were more likely from rural counties with significantly higher travel costs/visit ($60.77 vs $37.98, p = 0.026.) The majority expressed interest in using telemedicine (75.7%) or a smartphone app (87.5%) in their care. The majority of patients with difficulty attending appointments (88.9 vs 70.2%, p = 0.02) or from rural counties (88.7% vs 69.6%, p = 0.03) were interested in telemedicine; those with both characteristics reported 100% interest. The majority in both urban and rural counties had home internet access, and reported similarly high rates of daily use (79% vs 75%). Race and age were not associated with differences in internet access or use or telemedicine interest.
Telemedicine is attractive to the majority of patients and may offer financial/logistical advantages. Patients have high internet use rates and comfort with using technology for healthcare. Telemedicine should be incorporated into standard practice beyond the COVID-19 pandemic to reduce healthcare access disparities.
评估妇科肿瘤患者对远程医疗的接受程度,尤其是那些面临医疗服务获取差异风险的患者(距离医疗机构较远、农村人口等)。
2020年1月6日至2020年2月28日期间,在一家学术性综合癌症中心进行面对面门诊预约时,处于所有疾病/治疗阶段的患者完成了一项匿名调查,该调查在2019冠状病毒病大流行之前、本医疗机构引入远程医疗之前进行。
在180名被邀请的患者中,170名完成了调查(94.4%)。平均年龄为59.6岁;73.4%为白人,23.7%为黑人,2.9%为其他种族。卵巢癌最为常见(41.2%),其次是子宫内膜癌(27.1%)、宫颈癌(20.6%)和阴道/外阴癌(7.1%)。大多数患者前往预约地点的行程超过50英里(63.8%);他们更有可能来自农村县,每次就诊的交通成本显著更高(60.77美元对37.98美元,p = 0.026)。大多数患者表示有兴趣在其医疗护理中使用远程医疗(75.7%)或智能手机应用程序(87.5%)。大多数难以按时就诊的患者(88.9%对70.2%,p = 0.02)或来自农村县的患者(88.7%对69.6%,p = 0.03)对远程医疗感兴趣;同时具备这两个特征的患者表示100%感兴趣。城市和农村县的大多数人都能在家中使用互联网,且报告的日常使用率相似(79%对75%)。种族和年龄与互联网接入或使用情况以及对远程医疗的兴趣差异无关。
远程医疗对大多数患者具有吸引力,可能提供经济/后勤方面的优势。患者的互联网使用率较高,并且对使用技术进行医疗保健感到舒适。在2019冠状病毒病大流行之后,应将远程医疗纳入标准医疗实践,以减少医疗服务获取方面的差异。