Agarwal Mudit, Arushi Arushi, Dhingra Lovedeep Singh, Patel Lajjaben Jayeshkumar, Agrawal Samprati, Srivastava Padma, Tripathi Manjari, Srivastava Achal, Bhatia Rohit, Singh Mamta Bhushan, Prasad Kameshwar, Vibha Deepti, Vishnu Venugopalan Y, Rajan Roopa, Pandit Awadh Kishor, Singh Rajesh Kumar, Gupta Anu, Radhakrishnan Divya Madathiparambil, Das Animesh, Ramanujam Bhargavi, Agarwal Ayush, Elavarasi Arunmozhimaran
MBBS, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Telemed Rep. 2021 Mar 1;2(1):88-96. doi: 10.1089/tmr.2020.0034. eCollection 2021.
Teleneurology consultations can be highly advantageous since neurological diseases and disabilities often limit patient's access to health care, particularly in a setting where they need to travel long distances for specialty consults. Patient satisfaction is an important outcome assessing success of a telemedicine program. A cross-sectional study was conducted to determine satisfaction and perception of patients toward an audio call based teleneurology follow-up initiated during the coronavirus disease 2019 pandemic. Primary outcomes were satisfaction to tele-consult, and proportion of patients preferring telemedicine for future follow-up. A total of 261 patients who received tele-consult were enrolled. Satisfaction was highest for domain technological quality, followed by patient-physician dialogue (PPD) and least to quality of care (QoC). Median (interquartile range) patient satisfaction on a 5-point Likert scale was 4 (3-5). Eighty-five (32.6%; 95% confidence interval 26.9-38.6%) patients preferred telemedicine for future follow-up. Higher overall satisfaction was associated with health condition being stable/better, change in treatment advised on tele-consult, diagnosis not requiring follow-up examination, higher scores on domains QoC and PPD ( < 0.05). Future preference for telemedicine was associated with patient him-/herself consulting with doctor, less duration of follow-up, higher overall satisfaction, and higher scores on domain QoC ( < 0.05). On thematic analysis, telemedicine was found convenient, reduced expenditure, and had better physician attention; in-person visits were comprehensive, had better patient-physician relationship, and better communication. Patient satisfaction was lower in our study than what has been observed earlier, which may be explained by the primitive nature of our platform. Several variables related to the patients' disease process have an effect on patient satisfaction. Development of robust, structured platforms is necessary to fully utilize the potential of telemedicine in developing countries.
远程神经学会诊可能具有极大优势，因为神经疾病和残疾常常限制患者获得医疗保健的机会，尤其是在患者需要长途跋涉寻求专科会诊的情况下。患者满意度是评估远程医疗项目成功与否的一项重要指标。开展了一项横断面研究，以确定患者对在2019年冠状病毒病大流行期间启动的基于音频通话的远程神经学随访的满意度和看法。主要结果是对远程会诊的满意度以及患者对未来随访倾向于选择远程医疗的比例。共有261名接受远程会诊的患者被纳入研究。技术质量领域的满意度最高，其次是医患对话（PPD），而医疗质量（QoC）方面的满意度最低。在5分制李克特量表上，患者满意度的中位数（四分位间距）为4（3 - 5）。八十五名（32.6%；95%置信区间26.9 - 38.6%）患者倾向于在未来随访中选择远程医疗。总体满意度较高与健康状况稳定/好转、远程会诊时建议的治疗方案有变化、诊断不需要后续检查、QoC和PPD领域得分较高相关（<0.05）。未来对远程医疗的偏好与患者本人咨询医生、随访时间较短、总体满意度较高以及QoC领域得分较高相关（<0.05）。经主题分析发现，远程医疗方便、费用较低且医生关注度更高；面对面就诊全面、医患关系更好且沟通更佳。我们研究中的患者满意度低于先前观察到的水平，这可能是由于我们平台的原始性质所致。与患者疾病进程相关的几个变量会对患者满意度产生影响。在发展中国家，开发强大、结构化的平台对于充分发挥远程医疗的潜力至关重要。
