Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103596. doi: 10.1016/j.amjoto.2022.103596. Epub 2022 Aug 9.
To investigate the differential factors associated with physician satisfaction between telemedicine and in-person visits in otolaryngology.
Study data included 646 telemedicine and 365 in-person encounters delivered from May-June 2020 at a tertiary center outpatient setting. Encounter-specific physician satisfaction was rated by 15 otolaryngologists using Provider Satisfaction Questionnaire (range 0-100) consisted of 5 items (patient needs addressed, patient involvement, adequacy of information given, quality of emotion support provided, and general interaction satisfaction). A multivariable linear mixed-effects model was used to explore patient demographic and clinical factors associated with physician satisfaction.
Physician satisfaction scores for telemedicine and in-person visits were 83.0 [95 % CI: 77.0-88.9] and 88.1 [95 % CI: 82.5-93.6], respectively. Among telemedicine visits, physician satisfaction scores were significantly higher for follow-up (vs. new), videoconference (vs. telephone) encounters, and English-speaking patients in a multivariable model. New encounters had significantly lower satisfaction subdomain scores for adequacy of information given to the patient (β = -4.7 [95 % CI: -7.3 to -2.0], p = 0.001) and addressing the needs of the patient among telemedicine visits (β = -4.1, [95 % CI: -7.1 to -1.1], p = 0.007) while there were no differences in satisfaction scores between new vs follow-up visits among in-person visits. For non-English speaking patients, the physician satisfaction scores were significantly lower for subdomain scores assessing active patient participation (β = -13.1, [95 % CI: -13.1 to -17.4], p < 0.001) and emotional support given to the patient (β = -7.8, [95 % CI: -11.0 to -4.5], p < 0.001) for telemedicine visits.
Telemedicine has been broadly adopted as an alternative option to deliver care in otolaryngology since COVID-19 pandemic. Appropriate triaging based on patient and encounter characteristics may enhance physician satisfaction and overall experiences with telemedicine. Further efforts are needed to provide adequate interpretation and videoconference services during telemedicine visits.
调查在耳鼻喉科中，远程医疗和面对面就诊的医生满意度差异相关因素。
本研究的数据包括 2020 年 5 月至 6 月在一家三级中心的门诊环境中进行的 646 次远程医疗和 365 次面对面就诊。15 名耳鼻喉科医生使用满意度调查问卷（范围为 0-100）对每次就诊的医生满意度进行评分，该问卷由 5 个项目组成（患者需求得到满足、患者参与、提供的信息量、提供的情感支持质量和总体互动满意度）。使用多变量线性混合效应模型来探讨与医生满意度相关的患者人口统计学和临床因素。
远程医疗和面对面就诊的医生满意度评分分别为 83.0（95%CI：77.0-88.9）和 88.1（95%CI：82.5-93.6）。在远程医疗就诊中，与新就诊相比，随访就诊、视频会议就诊和讲英语的患者的医生满意度评分显著更高。在多变量模型中，新就诊的患者在满足患者需求（β=-4.7 [95%CI：-7.3 至-2.0]，p=0.001）和向患者提供信息量（β=-4.1 [95%CI：-7.1 至-1.1]）方面的满意度亚量表评分显著较低，而在面对面就诊中，新就诊与随访就诊之间的满意度评分没有差异。对于非英语患者，在评估患者积极参与（β=-13.1 [95%CI：-13.1 至-17.4]，p<0.001）和向患者提供情感支持（β=-7.8 [95%CI：-11.0 至-4.5]）的满意度亚量表评分方面，远程医疗就诊的医生满意度评分显著较低。
自 COVID-19 大流行以来，远程医疗已被广泛采用作为耳鼻喉科提供护理的替代选择。根据患者和就诊特点进行适当分诊，可能会提高医生满意度和远程医疗整体体验。在远程医疗就诊中，需要进一步努力提供充分的口译和视频会议服务。
