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通过视频远程医疗进行出院后随访服务的意愿:横断面研究。

Willingness to engage in post-discharge follow-up service conducted via video telemedicine: Cross-sectional study.

机构信息

School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China.

School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Shenzhen Longhua District People's Hospital, Shenzhen, Guangdong, China.

出版信息

Int J Med Inform. 2022 Dec;168:104885. doi: 10.1016/j.ijmedinf.2022.104885. Epub 2022 Oct 17.

Abstract

BACKGROUND

Leading influencing factors for telemedicine implementation remain unclear, affecting the focus of intervention strategies. Despite recent effectiveness evidence of video telemedicine visits, limited evidence exists regarding patients' willingness to use video follow-up. Moreover, patients' acceptance is crucial for implementing such services.

OBJECTIVE

We conducted a large-sample survey to analyze patient willingness and perceptions of post-discharge video follow-up and assessed the factors influencing their willingness during the COVID-19 outbreak.

METHOD

In February and March 2022, we conducted a face-to-face questionnaire survey involving inpatients in a tertiary care hospital in Longhua District, Shenzhen, China. We assessed demographics, health-related determinants, access to technology and literacy, preferences, willingness, and opinions toward video telemedicine follow-up. We implemented random forest and logistic regression analyses to obtain reliable results.

RESULTS

In total, 1,017 inpatients completed the survey. Overall, as an initial choice, 44.9 % preferred telephone consultation for post-discharge follow-up, which was followed by video telemedicine (17.1 %), WeChat voice calls (11.6 %), SMS text messages (10.7 %), WeChat graphic messages (10.5 %), and in-person visits (4.5 %). Moreover, 54.9 % were willing to experience video visits. The results highlight the perceived benefits outweighing the risks (OR 2.64, 95 % CI 1.76, 3.95), patients' trust in the physician (OR 2.41, 95 % CI 1.45, 3.99), access to a private space (OR 2.18, 95 % CI 1.01, 2.96), medium geographical distance (compared to long distance, OR 0.72, 95 % CI 0.54, 0.98), moderate disease (compared to mild disease, OR 0.75, 95 % CI 0.57, 0.99), followed by the comfort with video technology (OR 1.73, 95 % CI 1.76, 3.95), broadband internet accessibility (OR 1.56, 95 % CI 1.07, 2.27), privacy concerns (OR 0.62, 95 % CI 0.43, 0.89), and prior telemedicine video experience (OR 1.77, 95 % CI 1.15, 2.72), as factors influencing the willingness to use video follow-up.

CONCLUSIONS

A low percentage of patients chose video visits as their initial decisions; nevertheless, most had a positive attitude toward video follow-up visits. The willingness to choose video telemedicine post-discharge follow-up was influenced by geographical distance, disease severity, basic telemedicine requirements, physician-patient relationship, and perceptions of video communication.

摘要

背景

远程医疗实施的主要影响因素仍不清楚,这影响了干预策略的重点。尽管最近有视频远程医疗访问的有效性证据,但关于患者愿意使用视频随访的证据有限。此外,患者的接受度对于实施此类服务至关重要。

目的

我们进行了一项大样本调查,分析了患者在 COVID-19 大流行期间对出院后视频随访的意愿和看法,并评估了影响其意愿的因素。

方法

在 2022 年 2 月和 3 月,我们对中国深圳市龙华区一家三级医院的住院患者进行了面对面的问卷调查。我们评估了人口统计学、与健康相关的决定因素、技术和文化素养的获取、偏好、对视频远程医疗随访的意愿和意见。我们实施了随机森林和逻辑回归分析,以获得可靠的结果。

结果

共有 1017 名住院患者完成了调查。总体而言,作为初始选择,44.9%的患者更喜欢电话咨询作为出院后的随访方式,其次是视频远程医疗(17.1%)、微信语音通话(11.6%)、短信(10.7%)、微信图文消息(10.5%)和门诊(4.5%)。此外,54.9%的患者愿意体验视频访问。结果表明,感知到的益处超过了风险(OR 2.64,95%CI 1.76,3.95)、患者对医生的信任(OR 2.41,95%CI 1.45,3.99)、获得私人空间(OR 2.18,95%CI 1.01,2.96)、中等地理距离(与长距离相比,OR 0.72,95%CI 0.54,0.98)、中度疾病(与轻度疾病相比,OR 0.75,95%CI 0.57,0.99)、对视频技术的舒适度(OR 1.73,95%CI 1.76,3.95)、宽带互联网接入(OR 1.56,95%CI 1.07,2.27)、隐私问题(OR 0.62,95%CI 0.43,0.89)以及之前的远程医疗视频体验(OR 1.77,95%CI 1.15,2.72),这些都是影响使用视频随访意愿的因素。

结论

选择视频访问作为初始决策的患者比例较低;然而,大多数患者对视频随访持积极态度。选择视频远程医疗出院后随访的意愿受到地理距离、疾病严重程度、基本远程医疗要求、医患关系以及对视频沟通的看法的影响。

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