Rogers Miranda J, Belton Matthew, Randall Dustin, Yoo Minkyoung, Presson Angela P, Wang Angela, Kazmers Nikolas H
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT.
Department of Economics, University of Utah, Salt Lake City, UT.
J Hand Surg Glob Online. 2023 Mar 7;5(3):325-331. doi: 10.1016/j.jhsg.2023.02.004. eCollection 2023 May.
Our purpose was to identify patient characteristics and visit components that affect patient satisfaction with virtual new patient visits in an outpatient hand surgery clinic as measured by the Press Ganey Outpatient Medical Practice Survey (PGOMPS) total score (primary outcome) and provider subscore (secondary outcome).
Adult patients evaluated through virtual new patient visits at a tertiary academic medical center between January 2020 and October 2020 who completed the PGOMPS for virtual visits were included. Data regarding demographics and visit characteristics were collected via chart review. Factors associated with satisfaction were identified using a Tobit regression model on the continuous score outcomes (Total Score and Provider Subscore) to account for substantial ceiling effects.
A total of 95 patients were included: 54% were men and the mean age was 54 ± 16 years. Mean area deprivation index was 32 ± 18, and the mean driving distance to the clinic was 97 ± 188 mi. Common diagnoses include compressive neuropathy (21%), hand arthritis (19%), hand mass (12%), and fracture/dislocation (11%). Treatment recommendations included small joint injection (20%), in-person evaluation (25%), surgery (36%), and splinting (20%). Multivariable Tobit regressions showed notable differences in satisfaction by the provider on the Total Score but not on the Provider Subscore. Other factors known to affect the PGOMPS scores for in-person visits were not notably associated with the Total or Provider Sub-Scores for virtual visits (area deprivation index, age, and offer of surgery or injection) other than the body mass index.
Virtual clinic visit satisfaction was affected by the provider. Wait time strongly affects satisfaction with in-person visits but is not accounted for by the PGOMPS scoring system for virtual visits, which is a limitation of their survey. Further work is required to determine how to improve the patient experience with virtual visits.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
我们的目的是确定患者特征和就诊组成部分，这些因素会影响门诊手外科诊所虚拟初诊患者的满意度，该满意度通过Press Ganey门诊医疗实践调查（PGOMPS）总分（主要结果）和医生分项评分（次要结果）来衡量。
纳入2020年1月至2020年10月期间在一家三级学术医疗中心通过虚拟初诊进行评估并完成虚拟就诊PGOMPS的成年患者。通过病历审查收集人口统计学和就诊特征数据。使用Tobit回归模型对连续评分结果（总分和医生分项评分）确定与满意度相关的因素，以考虑显著的天花板效应。
共纳入95例患者：54%为男性，平均年龄为54±16岁。平均地区贫困指数为32±18，到诊所的平均驾车距离为97±188英里。常见诊断包括压迫性神经病变（21%）、手部关节炎（19%）、手部肿物（12%）和骨折/脱位（11%）。治疗建议包括小关节注射（20%）、当面评估（25%）、手术（36%）和夹板固定（20%）。多变量Tobit回归显示，医生对总分的满意度存在显著差异，但对医生分项评分无显著差异。除体重指数外，其他已知影响当面就诊PGOMPS评分的因素与虚拟就诊的总分或医生分项评分无显著相关性（地区贫困指数、年龄以及手术或注射建议）。
虚拟诊所就诊满意度受医生影响。等待时间强烈影响当面就诊的满意度，但虚拟就诊的PGOMPS评分系统未考虑这一点，这是该调查的一个局限性。需要进一步开展工作以确定如何改善虚拟就诊的患者体验。
研究类型/证据水平：预后IV级。
