Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 45 Francis Street ASBII 3 rdFloor, Boston, MA, USA.
Laboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Obes Surg. 2024 Jun;34(6):2084-2090. doi: 10.1007/s11695-024-07250-0. Epub 2024 Apr 30.
The COVID-19 pandemic saw an acceleration in virtual-visits (VV) for healthcare delivery. However, the impact of virtual care in metabolic/bariatric surgery (MBS) programs is not well described.
Appointment data from three time-points: pre-pandemic (1/1/19-3/15/20, n = 19,290), pandemic (3/16/20-10/31/21, n = 29,459) and current-state (11/1/21-12/31/2022, n = 24,270) was retrieved in our multi-hospital ambulatory MBS program. Appointments were grouped by health care provider (HCP) (MD, dietician, and psychologist) and type (VV and in-person). Surveys assessing patient satisfaction were distributed electronically. All pre-op and post-op appointment data was analyzed for the time-points above. Appointment completion rates and patient reported preferences were described.
Our data showed an increase in scheduled VV from 0.5% for all HCP visits to 81% during the pandemic and a current VV visit of 77%. The number of completed VV increased for all HCPs, most prominently for dieticians. Parallel to this, the percentage of no-show visits also improved for all HCP, with MDs having the lowest no-show rate currently. Survey data revealed 89% of patients experience added benefits with VV and > 90% reported their VV experience as very good. VV were preferred over in-person visits for psychologists and dietitians (> 61%), but the majority preferred to see MDs in-person (70%).
Our findings reveal significant changes in healthcare utilization trends since the transition to virtual care. While overall satisfaction with virtual care is high, most patients prefer in-person visits with MDs. Thus, multi-disciplinary MBS care can be performed effectively using a hybrid model to ensure efficient distribution of resources.
在 COVID-19 大流行期间,医疗保健服务加速采用了虚拟就诊(VV)。然而,虚拟护理在代谢/减重手术(MBS)项目中的影响尚未得到充分描述。
从三个时间点检索了我们多医院门诊 MBS 计划中的预约数据:大流行前(1/1/19-3/15/20,n=19290)、大流行期间(3/16/20-10/31/21,n=29459)和当前状态(11/1/21-12/31/2022,n=24270)。预约根据医疗保健提供者(HCP)(MD、营养师和心理学家)和类型(VV 和面对面)进行分组。通过电子方式分发了评估患者满意度的调查。分析了上述所有术前和术后预约数据。描述了预约完成率和患者报告的偏好。
我们的数据显示,所有 HCP 就诊的预约 VV 从 0.5%增加到大流行期间的 81%,目前的 VV 就诊率为 77%。所有 HCP 的 VV 预约数量都有所增加,营养师的增幅最大。与此平行,所有 HCP 的未到诊率也有所提高,目前 MD 的未到诊率最低。调查数据显示,89%的患者在 VV 中体验到了额外的好处,超过 90%的患者报告他们的 VV 体验非常好。心理学家和营养师更喜欢 VV 而不是面对面就诊(>61%),但大多数患者更喜欢与 MD 面对面就诊(70%)。
我们的发现揭示了自向虚拟护理过渡以来医疗保健利用趋势的重大变化。虽然对虚拟护理的总体满意度很高,但大多数患者更喜欢与 MD 面对面就诊。因此,多学科 MBS 护理可以通过混合模式有效地进行,以确保资源的有效分配。