Kim Billy I, Peairs Emily, Lander Sarah, Antonelli Christopher, Lau Brian C
Duke University School of Medicine, Durham, North Carolina, USA.
Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.
Orthop J Sports Med. 2022 Oct 21;10(10):23259671221127721. doi: 10.1177/23259671221127721. eCollection 2022 Oct.
The adoption of telehealth visits for physical therapy (PT) has accelerated because of the COVID-19 pandemic. Patient reception of virtual PT at the outbreak of the pandemic was positive, but it is unclear how telehealth visits compare to in-person visits in the postpandemic era.
To evaluate utilization trends and patient satisfaction with virtual PT compared with in-person PT during and after the COVID-19 pandemic.
Cross-sectional study; Level of evidence, 3.
We identified 59,461 in-person and 2016 telehealth visits at a single physical rehabilitation center between March 2020 and December 2021. Patient socioeconomic and demographic variables, including insurance status, were compared between telehealth users and in-person visitors. A total of 1012 patient satisfaction surveys were available and analyzed using the top-box method. Univariable statistics ( test or Mann-Whitney and chi-square tests) were used for group comparisons.
Overall, telehealth users when compared with in-person visitors were older (median age, 47 vs 42 years, respectively; < .001), and a higher proportion was female (60.6% vs 54.8%; < .001), was White (69.7% vs 66.6%; = .023), spoke English as their primary language (99.2% vs 98.1%; = .001), and had Medicare insurance (20.3% vs 16.1%; < .001). Telehealth patients more often lived out-of-county (50.7% vs 45.8%; < .001) and in small towns rather than in urban areas (1.0% vs 0.3%; < .001). When we compared telehealth use before and after official reopening of the PT center in September 2020, telehealth users in the postpandemic era had an out-of-county rate of 58.7%, and 68.7% were female. Patient satisfaction survey results demonstrated that telehealth patients compared with in-person patients were less likely to recommend visits to others (75.0% vs 89.1%, respectively; = .008) and had lower overall assessment of their visits (71.7% vs 88.6%; = .001). Accordingly, there was a significant reduction in telehealth visits from 2020 to 2021 (from 6.9% to 0.9% of visits; < .001).
We noted a decline in telehealth PT use during the postpandemic era, consistent with reduced patient satisfaction when compared with in-person visits. Telehealth is a useful option for populations with limited time or access to care and may serve a role in a hybrid care model. Further studies on long-term outcomes after telehealth PT are warranted to evaluate its efficacy.
由于新冠疫情，物理治疗（PT）采用远程医疗问诊的情况加速发展。在疫情爆发时患者对虚拟物理治疗的接受度是积极的，但尚不清楚在疫情后时代远程医疗问诊与面对面问诊相比情况如何。
评估新冠疫情期间及之后虚拟物理治疗与面对面物理治疗相比的使用趋势和患者满意度。
横断面研究；证据等级，3级。
我们确定了2020年3月至2021年12月期间在一个物理康复中心的59461次面对面问诊和2016次远程医疗问诊。比较了远程医疗用户和面对面就诊者的患者社会经济和人口统计学变量，包括保险状况。共有1012份患者满意度调查问卷可用，并采用顶格法进行分析。单变量统计（t检验或曼-惠特尼U检验以及卡方检验）用于组间比较。
总体而言，与面对面就诊者相比，远程医疗用户年龄更大（中位年龄分别为47岁和42岁；P<0.001），女性比例更高（60.6%对54.8%；P<0.001），是白人的比例更高（69.7%对66.6%；P = 0.023），以英语作为主要语言的比例更高（99.2%对98.1%；P = 0.001），拥有医疗保险的比例更高（20.3%对16.1%；P<0.001）。远程医疗患者更常居住在县外（50.7%对45.8%；P<0.001）且居住在小镇而非城市地区（1.0%对0.3%；P<0.001）。当我们比较2020年9月物理治疗中心正式重新开放前后的远程医疗使用情况时，疫情后时代的远程医疗用户县外居住率为58.7%，女性占68.7%。患者满意度调查结果表明，与面对面就诊的患者相比，远程医疗患者向他人推荐就诊的可能性较小（分别为75.0%对89.1%；P = 0.008），对就诊的总体评价较低（71.7%对88.6%；P = 0.001）。因此，2020年至2021年远程医疗问诊显著减少（从就诊次数的6.9%降至0.9%；P<0.001）。
我们注意到在疫情后时代远程医疗物理治疗的使用有所下降，这与与面对面就诊相比患者满意度降低一致。远程医疗对于时间有限或获得医疗服务机会有限的人群是一个有用的选择，并且可能在混合护理模式中发挥作用。有必要对远程医疗物理治疗后的长期结果进行进一步研究以评估其疗效。
