Patel Prem N, Patel Parth A, Bhagat Davis, Chittaluru Neha, Bhatt Harit, Jager Rama, George Meena, Sheth Veeral
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Ophthalmology, Medical College of Georgia, Augusta, GA, USA.
Ophthalmol Ther. 2022 Oct;11(5):1925-1936. doi: 10.1007/s40123-022-00555-2. Epub 2022 Aug 3.
INTRODUCTION: Amidst the COVID-19 pandemic, telemedicine has emerged as a safe and cost-effective alternative to traditional ophthalmology clinic visits. This study evaluated patient attitudes towards telemedicine at a full-service, retina-only practice to identify areas for growth in implementation. METHODS: A survey was distributed to established patients at University Retina and Macula Associates following the completion of a telemedicine encounter in July 2021. On a 5-point Likert scale, patients compared telemedicine to in-person visits for six domains: ability to ease COVID-related anxiety, efficiency, patient education, quality of care, fulfillment of personal needs, and convenience. Pearson's χ and Fisher's exact test were used to assess correlations between demographic factors and patient attitudes or preference towards telemedicine. RESULTS: Among 103 respondents, two-thirds (68.7%) preferred in-person compared to telemedicine encounters. Overall, patients had a neutral attitude towards telemedicine [mean Likert rating (SD) = 3.11/5 ± 0.82]. Questions assessing "patient education" and "telemedicine efficiency" received the greatest proportion of positive and negative responses, respectively. Positive attitudes were more frequent among patients with prior telemedicine experience (87.5%) compared to never-users (71.8%; p = 0.046). Patients ≥ 75 years old tended to negatively assess telemedicine regarding reduction of COVID-19-related anxiety, efficiency, patient education, and physician facetime (p < 0.05 for all). A positive but non-significant trend was observed between higher education level and positive attitude towards telemedicine (p = 0.18). Telehealth never-users more often negatively rated receiving adequate facetime with the physician virtually (54.7%) compared to prior users (25.6%; p = 0.004). Younger age, prior history of telemedicine use, and higher education level were associated with increased preference for telemedicine (p < 0.05 for all). CONCLUSION: Our findings revealed hesitance remains among patients towards adoption of telemedicine. Targeting age-, experience-, and education-related barriers will be invaluable for increasing acceptance of this healthcare delivery model.
引言：在新冠疫情期间，远程医疗已成为传统眼科门诊就诊的一种安全且具成本效益的替代方式。本研究评估了一家提供全方位视网膜专科服务机构的患者对远程医疗的态度，以确定实施过程中的发展方向。 方法：在2021年7月完成一次远程医疗会诊后，向大学视网膜与黄斑专科诊所的现有患者发放了一份调查问卷。患者采用5分李克特量表，就六个方面将远程医疗与面对面就诊进行比较：缓解与新冠相关焦虑的能力、效率、患者教育、护理质量、个人需求满足度以及便利性。使用皮尔逊卡方检验和费舍尔精确检验来评估人口统计学因素与患者对远程医疗的态度或偏好之间的相关性。 结果：在103名受访者中，三分之二（68.7%）的人更喜欢面对面就诊而非远程医疗会诊。总体而言，患者对远程医疗持中立态度[平均李克特评分（标准差）=3.11/5±0.82]。评估“患者教育”和“远程医疗效率”的问题分别获得了最大比例的积极和消极回答。有远程医疗经验的患者（87.5%）比从未使用过的患者（71.8%）更常持积极态度（p=0.046）。75岁及以上的患者在减少与新冠-19相关焦虑、效率、患者教育和医生面对面交流时间方面往往对远程医疗给予负面评价（所有p值均<0.05）。在高等教育水平与对远程医疗的积极态度之间观察到一个积极但不显著的趋势（p=0.18）。与之前的使用者（25.6%）相比，从未使用过远程医疗的患者更多地对虚拟状态下与医生有足够的面对面交流时间给予负面评价（54.7%）（p=0.004）。年龄较小、有远程医疗使用史以及高等教育水平与对远程医疗的偏好增加相关（所有p值均<0.05）。 结论：我们的研究结果显示患者在采用远程医疗方面仍存在犹豫。针对与年龄、经验和教育相关的障碍对于提高这种医疗服务模式的接受度将非常重要。
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