评估中国直接面向消费者的远程医疗的质量:一项使用突击标准化病人的横断面研究

IF 5.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Zhen Zeng, Dong (Roman) Xu, Yiyuan Cai, Wenjie Gong
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引用次数: 0

摘要

作为传统医疗的一种替代方式,直接面向消费者的远程医疗(DTCT)已广受欢迎。然而,由于缺乏全面的质量评估,其潜在风险的不确定性可能会影响其长期发展。本研究旨在评估中国 DTCT 平台在 2021 年 7 月至 2022 年 1 月期间使用突击标准化病人(USP)所提供的医疗质量。研究采用美国医学会质量框架,对医院和企业赞助平台的咨询服务进行了评估。研究采用了 10 个 USP 病例,涵盖糖尿病、哮喘、普通感冒、胃炎、心绞痛、腰背痛、儿童腹泻、儿童皮炎、压力性尿失禁和产后抑郁症等病症。研究人员采用了描述性分析和回归分析来检查平台特征,并比较不同类型平台的质量。结果显示,在107个不同远程医疗平台的170次USP访问中,企业赞助的平台实现了100%的访问成功率,而医院赞助的平台成功率仅为47.5%(56/118)。分析结果表明,所有平台的总体诊断正确率都很低,仅为 45%,而且没有充分遵守临床指南。值得注意的是,与医院赞助的平台相比,企业赞助的平台在可及性、响应时间和病例管理方面表现更佳。这项研究凸显了中国 DTCT 平台的质量不尽如人意,尤其是医院发起的平台。为进一步加强 DTCT 服务,未来的研究应将 DTCT 与面对面治疗进行比较,旨在找出将 DTCT 作为传统治疗的替代或补充所存在的差距和潜在风险。未来在加强 DTCT 服务方面的发展潜力可能包括探索将医院资源与企业赞助平台的技术和市场能力相结合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing quality of direct-to-consumer telemedicine in China: a cross-sectional study using unannounced standardised patients
Direct-to-onsumer telemedicine (DTCT) has become popular as an alternative to traditional care. However, uncertainties about the potential risks associated with the lack of comprehensive quality evaluation could influence its long-term development. This study aimed to assess the quality of care provided by DTCT platforms in China using unannounced standardised patients (USP) between July 2021 and January 2022. The study assessed consultation services on both hospital and enterprise-sponsored platforms using the Institute of Medicine quality framework. It employed 10 USP cases, covering conditions such as diabetes, asthma, common cold, gastritis, angina, low back pain, child diarrhoea, child dermatitis, stress urinary incontinence and postpartum depression. Descriptive and regression analyses were employed to examine platform characteristics and compare quality across platform types. The results showed that of 170 USP visits across 107 different telemedicine platforms, enterprise-sponsored platforms achieved a 100% success in access, while hospital-sponsored platforms had a success rate of only 47.5% (56/118). Analysis highlighted a low overall correct diagnosis rate of 45% and inadequate adherence to clinical guidelines across all platforms. Notably, enterprise-sponsored platforms outperformed in accessibility, response time and case management compared with hospital-sponsored platforms. This study highlights the suboptimal quality of DTCT platforms in China, particularly for hospital-sponsored platforms. To further enhance DTCT services, future studies should compare DTCT and in-person care, aiming to identify gaps and potential risks associated with using DTCT as alternatives or supplements to traditional care. The potential of future development in enhancing DTCT services may involve exploring the integration of hospital resources with the technology and market capabilities of enterprise-sponsored platforms.
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来源期刊
BMJ Quality & Safety
BMJ Quality & Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
9.80
自引率
7.40%
发文量
104
审稿时长
4-8 weeks
期刊介绍: BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement. The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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