From the Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (Dr. O'Donnell, Haberli, Dr. Martinez, and Dr. Warner); the Avant-garde Health, Boston, MA (Yagoda); and the Harvard Business School, Boston, MA (Dr. Kaplan).
J Am Acad Orthop Surg Glob Res Rev. 2022 Jul 6;6(7). doi: 10.5435/JAAOSGlobal-D-22-00119. eCollection 2022 Jul 1.
Studies comparing the cost of in-person and virtual care are lacking. The goal of this study was threefold (1) to compare the cost of telemedicine visits with in-person clinic visits after common shoulder surgeries, (2) to measure the safety, and (3) to evaluate patient experience with telemedicine visits.
The In-Person Visit cohort (N = 25) and the telemedicine cohort (Virtual Visit cohort, N = 24) were selected from patients undergoing routine follow-up of common shoulder procedures. Time-driven activity-based costing was used to determine costs associated with each episode of care. Patient complications, satisfaction, convenience, and technical difficulties associated with telehealth were recorded.
The average Virtual Visit was 54.1% less costly and 87.8% shorter than the In-Person Visit ($49 versus $107 per patient, 8.6 versus 70.1 minutes per patient, P < 0.01, respectively). One complication was missed in the Virtual Visit cohort, later captured by an in-person visit. All patients in the Virtual Visit cohort reported that the virtual visit was safe and convenient and showed high levels of satisfaction.
Virtual visits for postoperative care of patients undergoing shoulder surgery are associated with decreased costs and high ratings of convenience and satisfaction. Postoperative complications may be more challenging to diagnose virtually.
缺乏比较面对面和虚拟护理成本的研究。本研究的目的有三：（1）比较常见肩部手术后远程医疗访问与面对面诊所访问的成本，（2）衡量安全性，以及（3）评估远程医疗访问的患者体验。
从接受常见肩部手术常规随访的患者中选择面对面访问队列（N=25）和远程医疗队列（虚拟访问队列，N=24）。使用时间驱动的基于活动的成本核算来确定与每次护理相关的成本。记录与远程医疗相关的患者并发症、满意度、便利性和技术困难。
平均虚拟访问的成本比面对面访问低 54.1%，时间短 87.8%（每位患者 49 美元与 107 美元，每位患者 8.6 分钟与 70.1 分钟，P<0.01）。虚拟访问队列中漏诊了一例并发症，后来通过面对面就诊发现。虚拟访问队列中的所有患者均报告虚拟访问安全且方便，并表现出高度满意度。
肩部手术后患者术后护理的虚拟访问与降低成本以及便利性和满意度高有关。虚拟访问可能更难以诊断术后并发症。
