Tang Sherry Y Q, Ganesh Kumar Nishant, Mirza Humza, Breuler Christopher J, Squitieri Lee, Chung Kevin C, Momoh Adeyiza O
From the Section of Plastic Surgery, Department of Surgery, University of Michigan.
Department of Surgery, Division of Plastic Surgery, City of Hope National Medical Center.
Plast Reconstr Surg. 2025 May 1;155(5):947e-953e. doi: 10.1097/PRS.0000000000011696. Epub 2024 Aug 23.
Various surgical subspecialties, including plastic surgery, have begun to embrace virtual clinic visits, especially since the COVID-19 pandemic. However, the impact of video visits on time optimization and cost incurred in outpatient plastic surgery clinics has not been studied.
Using the time-driven activity-based costing method, the authors examined the time and cost of in-person and virtual visits at an academic plastic surgery clinic. The authors formulated process maps for 4 visit types: physician-led in-person, physician assistant-led in-person, physician-led virtual, and physician assistant-led virtual. The time associated with each visit type was generated by direct observation. The cost associated with each visit type was calculated from representative salary information and estimation of resource costs.
On average, virtual visits took less time (25.3 minutes for physician-led visits and 24.4 minutes for physician assistant-led visits) compared with in-person visits (48.2 minutes for physician-led and 41.1 minutes for physician assistant-led visits) ( P < 0.001). Virtual visits were also less expensive, at $52.80 for physician-led visits and $20.70 for physician assistant-led visits, compared with in-person visits ($261.13 for physician-led and $236.00 for physician assistant-led visits). Nonprovider activities made up the majority of traditional in-person visits (75.7% of the visit for physician-led and 77.6% for physician assistant-led visits), which contributed to higher overall cost of in-person visits for both groups of providers.
Virtual clinic visits can produce time and cost savings without reducing the amount of face-to-face time between providers and patients. Virtual visits can be a useful adjunct to traditional in-person visits.
包括整形手术在内的各种外科亚专业领域已开始采用虚拟门诊，尤其是自新冠疫情以来。然而，视频门诊对门诊整形手术诊所的时间优化和成本产生的影响尚未得到研究。
作者采用基于时间驱动作业成本法，研究了一所学术性整形手术诊所的面对面门诊和虚拟门诊的时间及成本。作者为4种门诊类型制定了流程地图：医生主导的面对面门诊、医师助理主导的面对面门诊、医生主导的虚拟门诊和医师助理主导的虚拟门诊。每种门诊类型的相关时间通过直接观察得出。每种门诊类型的相关成本根据代表性薪资信息和资源成本估算得出。
平均而言，与面对面门诊（医生主导的为48.2分钟，医师助理主导的为41.1分钟）相比，虚拟门诊用时更少（医生主导的为25.3分钟，医师助理主导的为24.4分钟）（P < 0.001）。虚拟门诊成本也更低，医生主导的为52.80美元，医师助理主导的为20.70美元，而面对面门诊（医生主导的为261.13美元，医师助理主导的为236.00美元）。非医疗人员活动在传统面对面门诊中占大部分（医生主导门诊的75.7%，医师助理主导门诊的77.6%），这导致两组医疗人员的面对面门诊总体成本更高。
虚拟门诊可以节省时间和成本，同时不减少医疗人员与患者之间的面对面交流时间。虚拟门诊可以作为传统面对面门诊的有益补充。
