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术后远程医疗访问与面对面访问对患者满意度的影响:一项随机临床试验。

Impact of postoperative telemedicine visit versus in-person visit on patient satisfaction: A randomized clinical trial.

机构信息

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

出版信息

Surgery. 2023 Feb;173(2):322-327. doi: 10.1016/j.surg.2022.09.036. Epub 2022 Nov 13.

Abstract

BACKGROUND

Although telemedicine use has increased dramatically during the COVID-19 pandemic and beyond, the impact of telemedicine versus in-person postoperative visits on patient satisfaction has not been studied prospectively. We hypothesized that telemedicine visits would be noninferior to in-person visits in terms of postoperative colorectal surgery patient satisfaction.

METHODS

We conducted a randomized trial of consecutive adult patients undergoing transabdominal colorectal surgery from September 2020 to February 2021. Eligible participants were randomized 1:1 to either receive a telemedicine visit (Arm T) or an in-person visit (Arm I) for their first postoperative appointment. Subsequently, participants in Arm T completed a second postoperative visit in person, and participants in Arm I completed a second postoperative visit via telemedicine. All participants completed a patient satisfaction survey electronically within 24 hours after each postoperative visit. The primary endpoint was total patient satisfaction score. Secondary endpoints included patient-reported safety score, length of visit, and willingness of patients to recommend the practice to their peers. Fisher's exact test, χ analysis, and Student's t test were used to compare outcomes.

RESULTS

A total of 46 patients were analyzed with 23 each in Arm T and Arm I. The mean age of our study cohort was 50.6 (standard deviation 17.7) years and 52% were female. No significant differences were found between groups in terms of baseline characteristics. With respect to our primary endpoint of total satisfaction score, patient satisfaction scores in Arm T were non-inferior to those in Arm I. Similarly, there was no significant difference in satisfaction scores after the second postoperative visit when the visit types were reversed. We did not find any significant differences between groups in terms of our secondary endpoints.

CONCLUSION

Postoperative telemedicine visits were a safe and time-efficient option that maintained high patient satisfaction compared with in-person postoperative visits.

摘要

背景

尽管在 COVID-19 大流行期间及之后,远程医疗的使用急剧增加,但远程医疗与面对面术后访视对患者满意度的影响尚未前瞻性研究。我们假设,在术后结直肠手术患者满意度方面,远程医疗访视不劣于面对面访视。

方法

我们进行了一项连续成年患者接受经腹结直肠手术的随机试验,时间为 2020 年 9 月至 2021 年 2 月。符合条件的参与者按 1:1 随机分为接受远程医疗访视(T 组)或面对面访视(I 组)进行首次术后预约。随后,T 组的参与者亲自完成第二次术后访视,I 组的参与者通过远程医疗完成第二次术后访视。所有参与者在每次术后访视后 24 小时内通过电子方式完成患者满意度调查。主要终点是总患者满意度评分。次要终点包括患者报告的安全性评分、访视时间和患者向同行推荐该实践的意愿。Fisher 精确检验、χ 分析和学生 t 检验用于比较结果。

结果

共分析了 46 例患者,每组 23 例。我们研究队列的平均年龄为 50.6(标准差 17.7)岁,52%为女性。两组在基线特征方面无显著差异。关于我们的主要终点总满意度评分,T 组的患者满意度评分不劣于 I 组。同样,当访视类型反转时,第二次术后访视后的满意度评分也没有显著差异。我们没有发现两组在次要终点方面有任何显著差异。

结论

与面对面术后访视相比,术后远程医疗访视是一种安全且高效的选择,可保持较高的患者满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f94/9659327/ef4bd2756040/gr1_lrg.jpg

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