Department of Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
Department of Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
J Clin Neurosci. 2021 Dec;94:18-23. doi: 10.1016/j.jocn.2021.09.013. Epub 2021 Oct 5.
While recent studies have focused on confirming satisfaction with telemedicine during the coronavirus disease 2019 (COVID-19) era, we leveraged a novel survey instrument to identify associations between patient experience and telemedicine-specific factors such as device selection, audio/visual resolution, and connection stability.
Telemedicine visit data were gathered from our institution between June 22, 2020 and February 14, 2021. Each patient indicated their overall visit score, likelihood-to-recommend (LTR) score, and device used for the encounter. Remaining questions were randomly distributed to patients to ensure equal distribution across respondents.
Over 34 weeks, there were 901 unique neurosurgical telemedicine visits linked to a post-visit survey at our institution. The LTR top box score percentage showed no significant change across 34 weeks (p = 0.218). After adjusting across available covariates, patients who experienced wait times exceeding 20 min were significantly less likely to report high overall scores (aOR: 0.12; 95% CI: 0.03-0.41; p = 0.001). Patients who indicated they were less able to understand the provider (aOR: 0.22; 95% CI: 0.07-0.66; p = 0.007), or who indicated the provider was not able to properly see them (aOR: 0.11; 95% CI: 0.03-0.43; p = 0.002) were associated with substantially lower overall scores. Visits with interrupted connectivity or those forced to move to a regular phone call were not important predictors of overall score.
In the largest description of patient satisfaction with telemedicine in the neurosurgical setting during the COVID-19 era, we identified timely and high-quality physician-patient visualization and communication as among the most important predictors of patient satisfaction in virtual settings.
虽然最近的研究集中在确认在 2019 年冠状病毒病（COVID-19）期间对远程医疗的满意度，但我们利用一种新的调查工具来确定患者体验与远程医疗特定因素之间的关联，例如设备选择、音频/视频分辨率和连接稳定性。
我们于 2020 年 6 月 22 日至 2021 年 2 月 14 日从我们的机构收集远程医疗就诊数据。每位患者都给出了他们的整体就诊评分、推荐可能性（LTR）评分和就诊时使用的设备。其余问题随机分发给患者，以确保受访者的分布均匀。
在 34 周内，我们的机构共进行了 901 次独特的神经外科远程医疗就诊，并对就诊后调查进行了链接。LTR 最高分的百分比在 34 周内没有显著变化（p=0.218）。在调整了所有可用的协变量后，等待时间超过 20 分钟的患者报告整体评分较高的可能性显著降低（aOR：0.12；95%CI：0.03-0.41；p=0.001）。患者表示他们更难以理解提供者（aOR：0.22；95%CI：0.07-0.66；p=0.007）或表示提供者无法正确看到他们的（aOR：0.11；95%CI：0.03-0.43；p=0.002），与整体评分显著降低有关。连接中断或被迫转为普通电话的就诊不是整体评分的重要预测因素。
在 COVID-19 时代神经外科远程医疗患者满意度的最大描述中，我们发现及时、高质量的医患可视化和沟通是虚拟环境中患者满意度的最重要预测因素之一。
