COVID-19背景下患者年龄对远程医疗可接受性的影响

Brian Williams, Katelin McDilda, Melissa Bright
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摘要

该研究的目的是确定在COVID-19背景下,不同年龄组的患者在多大程度上认为远程医疗是一种可行的医疗服务模式。一份RedCap调查被发送到我们的妇产科门诊,在2020-3-11至2020-5-11之间进行面对面、远程医疗、重新安排或取消预约的患者。使用5分李克特量表分析患者的在线反应。采用χ 2和Fischer精确分析进行统计学分析,p < 0.05为显著性。共有1083名患者完成了调查,其中280名(25.9%)有远程医疗预约。患者回答了与远程医疗访问有关的问题。虽然老年患者确实遇到了更高比例的技术困难(p<0.0001),但年轻患者,特别是25-34岁年龄组的患者,对他们的预约被改为远程医疗表达了比老年患者更大的不满(p=0.02),并且认为远程医疗没有实现与亲自就诊相同的目标(p=0.01)。尽管如此,所有患者,不论年龄,都对远程医疗的介绍(p=0.02)和就诊前提供的指导(p=0.02)感到满意。连接问题似乎是老年患者最大的障碍,特别是在缺乏可靠的互联网连接和远程医疗兼容设备的情况下。年轻患者虽然不太满意,但对新技术和使用远程医疗更适应;他们往往较少遇到连接问题。我们今后的重点应该是寻找简化流程的方法,克服连接问题,同时解决导致患者不满的主要原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Patient Age on the Acceptability of Telemedicine in the Context of COVID-19
The objective of the study was to determine the extent to which patients from various age groups perceive telemedicine as a viable mode of healthcare delivery in the context of COVID-19. A RedCap survey was sent to patients in our OB/GYN outpatient clinics with in-person, telemedicine, re-scheduled or cancelled appointments between 3/11/20 to 5/11/20. Patients’ online responses were analyzed using a 5-point Likert scale. Statistical analysis was performed using Chi-Square and Fischer’s Exact Analysis with p < 0.05 considered significant. A total of 1083 patients completed the survey of whom 280 (25.9%) had a telemedicine appointment. Patients answered questions relating to their telemedicine visit. While older patients did encounter a higher proportion of technological difficulties (p<0.0001), younger patients, specifically those in the 25-34 age group, expressed greater dissatisfaction with their appointment being changed to telemedicine than older patients (p=0.02), and felt that telemedicine did not accomplish the same goals as an in-person visit (p=0.01). Nonetheless, all patients, regardless of age, were satisfied with the introduction to telemedicine (p=0.02) and the instructions provided to them prior to the visit (p=0.02). Connectivity issues seem to be the biggest obstacle to older patients particularly when there is absence of a reliable internet connection and a telemedicine-compatible device. Younger patients, though less satisfied, are more comfortable with new technology and with using telemedicine; they tend to experience less connectivity issues. Our focus going forward should be on finding ways to simplify the process, overcome the connectivity issues while addressing the main reasons leading to patient dissatisfaction.
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