Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care
Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care
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DOI：
10.3399/bjgp19x704573
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发表时间：
2019-09-01
影响因子：
5.9
通讯作者：
McKinstry, Brian
中科院分区：
文献类型：
--
作者：
Hammersley, Victoria;Donaghy, Eddie;McKinstry, Brian
背景对初级保健服务日益增长的需求导致决策者推广视频咨询（VC）以取代常规的面对面咨询（FTFC）。目的探讨VC、电话（TC）的内容、质量和患者体验，和FTFCs在一般的做法。设计和settingComparison的录音的后续磋商在英国primary care.MethodPrimary care临床医生提供了视频-咨询设备。参与患者需要智能手机、平板电脑或带摄像头的电脑。临床医生邀请需要随访的患者选择VC、TC或FTFC。对磋商进行了录音，并分析了内容和质量。参与者的经验进行了探讨后咨询问卷。病例记录进行了审查NHS资源use.ResultsOf录音，149/163适合分析。VC招募的人更年轻，在网上交流方面更有经验。FTFC比VC长（平均差异+3.7分钟。95%置信区间[CI] = 2.1至5.2）或TC（+4.1分钟，95% CI = 2.6至5.5）。平均而言，与FTFC（平均2.1，标准差[SD] 0.8）相比，患者在VC中提出的问题较少（平均1.5，标准差[SD] 0.8）。SD 1.1），临床医生和患者提供信息的情况较少。FTFC得分高于VC和TC的咨询质量items.ConclusionVC可能是适合于简单的问题，不需要体检。在咨询时间、内容和质量方面，自愿咨询与技术咨询相似。这两种方法似乎都不如FTFC信息丰富。技术问题是常见的，虽然病人真的很喜欢VC。在将技术和方法纳入初级保健主流之前，需要解决基础设施问题。
BackgroundGrowing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice.AimTo explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice.Design and settingComparison of audio-recordings of follow-up consultations in UK primary care.MethodPrimary care clinicians were provided with video-consulting equipment. Participating patients required a smartphone, tablet, or computer with camera. Clinicians invited patients requiring a follow-up consultation to choose a VC, TC, or FTFC. Consultations were audio-recorded and analysed for content and quality. Participant experience was explored in post-consultation questionnaires. Case notes were reviewed for NHS resource use.ResultsOf the recordings, 149/163 were suitable for analysis. VC recruits were younger, and more experienced in communicating online. FTFCs were longer than VCs (mean difference +3.7 minutes. 95% confidence interval [CI] = 2.1 to 5.2) or TCs (+4.1 minutes, 95% CI = 2.6 to 5.5). On average, patients raised fewer problems in VCs (mean 1.5, standard deviation [SD] 0.8) compared with FTFCs (mean 2.1. SD 1.1) and demonstrated fewer instances of information giving by clinicians and patients. FTFCs scored higher than VCs and TCs on consultation-quality items.ConclusionVC may be suitable for simple problems not requiring physical examination. VC, in terms of consultation length, content, and quality, appeared similar to TC. Both approaches appeared less Information rich' than FTFC. Technical problems were common and, though patients really liked VC. infrastructure issues would need to be addressed before the technology and approach can be mainstreamed in primary care.