CERGAS SDA Bocconi, Bocconi University, Milan, Italy.
Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
BMC Health Serv Res. 2023 Jun 22;23(1):682. doi: 10.1186/s12913-023-09575-5.
The beginning of the Covid-19 pandemic has forced many hospital departments worldwide to implement telehealth strategies for the first time. Telehealth represents the opportunity to increase value for all stakeholders, including patients and healthcare staff, but its success constitutes a challenge for all of them and particularly patients play a crucial role for their needed adherence. This study focuses on the experience of the Rheumatology Unit of Niguarda Hospital in Milan (Italy), where telehealth projects have been implemented for more than a decade with structured design and organized processes. The case study is paradigmatic because patients have experimented personalized mixes of telehealth channels, including e-mails and phone calls, Patient Reported Outcomes questionnaires, and home delivery of drugs. Given all these peculiarities, we decided to deepen patients' perspective through three main aspects related to the adoption of telehealth: (i) the benefits perceived, (ii) the willingness to enrol in future projects, (iii) the preference on the service-mix between remote contacts and in-person visits. Most importantly, we investigated differences in the three areas among all patients based on the mix of telehealth channels experienced.
We conducted a survey from November 2021 to January 2022, enrolling consecutively patients attending the Rheumatology Unit of Niguarda Hospital in Milan (Italy). Our survey comprised an introductory set of questions related to personal, social, clinical and ICT skills information, followed by the central part on telehealth. All the answers were analysed with descriptive statistics and regression models.
A complete response was given by 400 patients: 283 (71%) were female, 237 (59%) were 40-64 years old, 213 (53%) of them declared to work, and the disease most represented was Rheumatoid Arthritis (144 patients, 36%). Descriptive statistics and regression results revealed that (i) non-users imagined wide-ranging benefits compared to users; (ii) other things being equal, having had a more intense experience of telehealth increased the odds of accepting to participate to future projects by 3.1 times (95% C.I. 1.04-9.25), compared to non-users; (iii) the more telehealth was experienced, the higher the willingness to substitute in-person with online contacts.
Our study contributes to enlighten the crucial role played by the telehealth experience in determining patients' preferences.
新冠疫情的爆发迫使全球许多医院部门首次实施远程医疗战略。远程医疗为所有利益相关者（包括患者和医护人员）带来了增加价值的机会，但它的成功对所有人来说都是一个挑战，尤其是患者在他们需要的坚持方面起着至关重要的作用。本研究聚焦于米兰尼瓜尔达医院（意大利）风湿病科的经验，该部门十多年来一直采用结构化设计和有组织的流程实施远程医疗项目。该案例研究具有代表性，因为患者已经体验过个性化的远程医疗渠道组合，包括电子邮件和电话、患者报告的结果问卷以及药物的上门配送。鉴于所有这些特点，我们决定通过与远程医疗采用相关的三个主要方面来深入了解患者的观点：（i）感知到的益处，（ii）参与未来项目的意愿，（iii）远程联系和面对面就诊之间服务组合的偏好。最重要的是，我们根据患者体验的远程医疗渠道组合，调查了这三个领域在所有患者中的差异。
我们于 2021 年 11 月至 2022 年 1 月进行了一项调查，连续招募了在米兰尼瓜尔达医院就诊的风湿病科患者。我们的调查包括一组与个人、社会、临床和信息通信技术技能信息相关的介绍性问题，随后是关于远程医疗的核心部分。所有答案均采用描述性统计和回归模型进行分析。
共有 400 名患者完整回答了问卷：283 名（71%）为女性，237 名（59%）为 40-64 岁，213 名（53%）有工作，最常见的疾病是类风湿关节炎（144 名患者，36%）。描述性统计和回归结果表明：（i）非使用者与使用者相比，想象中的益处更为广泛；（ii）在其他条件相同的情况下，与非使用者相比，远程医疗体验更为强烈，参与未来项目的可能性增加了 3.1 倍（95%CI 1.04-9.25）；（iii）远程医疗体验越多，替代面对面联系的意愿就越高。
我们的研究有助于阐明远程医疗体验在决定患者偏好方面所起的关键作用。
