澳大利亚全科医生对远程医疗咨询的偏好：一项试点调查和离散选择实验。

General practitioner preferences for telehealth consultations in Australia: a pilot survey and discrete choice experiment.

机构信息

Centre for Online Health, The University of Queensland, Brisbane, Australia.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

出版信息

Prim Health Care Res Dev. 2024 May 9;25:e28. doi: 10.1017/S1463423624000136.

DOI:10.1017/S1463423624000136

PMID:38721700

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11091543/

Abstract

AIM

To identify and quantify general practitioner (GP) preferences related to service attributes of clinical consultations, including telehealth consultations, in Australia.

BACKGROUND

GPs have been increasingly using telehealth to deliver patient care since the onset of the 2019 coronavirus disease (COVID-19) pandemic. GP preferences for telehealth service models will play an important role in the uptake and sustainability of telehealth services post-pandemic.

METHODS

An online survey was used to ask GPs general telehealth questions and have them complete a discrete choice experiment (DCE). The DCE elicited GP preferences for various service attributes of telehealth (telephone and videoconference) consultations. The DCE investigated five service attributes, including consultation mode, consultation purpose, consultation length, quality of care and rapport, and patient co-payment. Participants were presented with eight choice sets, each containing three options to choose from. Descriptive statistics was used, and mixed logit models were used to estimate and analyse the DCE data.

FINDINGS

A total of 60 GPs fully completed the survey. Previous telehealth experiences impacted direct preferences towards telehealth consultations across clinical presentations, although in-person modes were generally favoured (in approximately 70% of all scenarios). The DCE results lacked statistical significance which demonstrated undiscernible differences between GP preferences for some service attributes. However, it was found that GPs prefer to provide a consultation with good quality care and rapport ( < 002). GPs would also prefer to provide care to their patients rather than decline a consultation due to consultation mode, length or purpose ( < 0.0001). Based on the findings, GPs value the ability to provide high-quality care and develop rapport during a clinical consultation. This highlights the importance of recognising value-based care for future policy reforms, to ensure continued adoption and sustainability of GP telehealth services in Australia.

摘要

目的

确定并量化澳大利亚全科医生（GP）与临床咨询（包括远程医疗咨询）服务属性相关的偏好。

背景

自 2019 年冠状病毒病（COVID-19）大流行以来，GP 越来越多地使用远程医疗为患者提供护理。GP 对远程医疗服务模式的偏好将在大流行后远程医疗服务的采用和可持续性方面发挥重要作用。

方法

使用在线调查向 GP 提出一般远程医疗问题，并让他们完成离散选择实验（DCE）。DCE 引出了 GP 对远程医疗（电话和视频会议）咨询各种服务属性的偏好。DCE 调查了五个服务属性，包括咨询模式、咨询目的、咨询时长、护理质量和融洽度以及患者共付额。参与者会收到八个选择集，每个选择集中包含三个选项可供选择。使用描述性统计数据，使用混合对数模型对 DCE 数据进行估计和分析。

结果

共有 60 名 GP 完整完成了调查。以前的远程医疗经验会影响对各种临床表现的远程医疗咨询的直接偏好，尽管面对面模式通常更受欢迎（在所有情况下约有 70%）。DCE 的结果缺乏统计学意义，表明 GP 对某些服务属性的偏好没有明显差异。然而，研究发现，GP 更倾向于提供具有良好护理质量和融洽度的咨询（<0.002）。GP 也更愿意为患者提供护理，而不是因为咨询模式、时长或目的而拒绝咨询（<0.0001）。基于这些发现，GP 重视在临床咨询中提供高质量护理和建立融洽关系的能力。这凸显了为未来政策改革认可基于价值的护理的重要性，以确保澳大利亚 GP 远程医疗服务的持续采用和可持续性。