Department of Urology, University of Washington, Seattle, WA.
Department of Urology, University of Washington, Seattle, WA.
Urol Oncol. 2024 Dec;42(12):448.e17-448.e22. doi: 10.1016/j.urolonc.2024.07.015. Epub 2024 Aug 13.
Relaxed licensing restrictions on telehealth use during the COVID-19 pandemic allowed broad use irrespective of visit type. As these telehealth waivers expire, optimal uses of telehealth must be assessed to inform policy and clinical care. We evaluated patient experience associated with telehealth and in-person new or established visits.
Patients seen in-person and via telehealth for urologic cancer care from August 2019 to June 2022 received a survey on satisfaction with care, perceptions of communication during their visit, travel time, travel costs, and days of work missed. We assessed survey responses with descriptive statistics.
Surveys were completed for 1,031 patient visits (N = 494 new visits, N = 537 established visits). Satisfaction rates were high for all visit modalities among new and established patients (mean score range 59.9-60.7 [maximum 63], P > 0.05). Patient-rated quality of the encounter did not differ by visit type and modality (P > 0.05, for nearly all comparisons). New in-person patient visits were associated with significantly higher travel costs (mean $496.10, SD $1021) compared with new telehealth visits (mean $26.60, SD $141; P < 0.001); 27% of new in-person patients required plane travel and 41% required a hotel stay (P < 0.001 vs. 0.8% and 3.2% of new telehealth patients, respectively).
Satisfaction outcomes among patients with urologic cancer receiving new patient telehealth care equaled those of new patients cared for in-person while costs were significantly lower. Offering telehealth exemption beyond COVID-19 licensing waivers to include new patient visits would allow for ongoing delivery of high-quality urologic cancer care irrespective of geographic location.
在 COVID-19 大流行期间，放宽了对远程医疗使用的许可限制，使得无论就诊类型如何，都可以广泛使用远程医疗。随着这些远程医疗豁免的到期，必须评估远程医疗的最佳用途，以为政策和临床护理提供信息。我们评估了与远程医疗和现场新患者或已建立患者就诊相关的患者体验。
2019 年 8 月至 2022 年 6 月，接受泌尿外科癌症治疗的现场和远程医疗就诊的患者收到了一份关于护理满意度、就诊期间沟通感知、旅行时间、旅行费用和缺勤天数的调查。我们使用描述性统计数据评估了调查结果。
完成了 1031 次患者就诊的调查（N=494 次新就诊，N=537 次已建立就诊）。新患者和已建立患者对所有就诊方式的满意度均很高（平均评分范围为 59.9-60.7[最高 63]，P>0.05）。患者对就诊体验的评价不因就诊类型和方式而不同（P>0.05，几乎所有比较）。与新远程医疗就诊相比，新现场就诊的患者旅行费用显著更高（新现场患者就诊的平均费用为 496.10 美元，标准差为 1021 美元，新远程医疗就诊的平均费用为 26.60 美元，标准差为 141 美元，P<0.001）；27%的新现场就诊患者需要乘坐飞机旅行，41%需要入住酒店（分别与新远程医疗患者的 0.8%和 3.2%相比，P<0.001）。
接受新患者远程医疗护理的泌尿外科癌症患者的满意度与现场就诊的新患者相当，而成本显著降低。在 COVID-19 许可豁免之外，向新患者就诊提供远程医疗豁免将允许无论地理位置如何，都能持续提供高质量的泌尿外科癌症护理。
