Efficiency, Satisfaction, and Costs for Remote Video Visits Following Radical Prostatectomy: A Randomized Controlled Trial
Efficiency, Satisfaction, and Costs for Remote Video Visits Following Radical Prostatectomy: A Randomized Controlled Trial
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DOI：
10.1016/j.eururo.2015.04.002
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发表时间：
2015-10-01
期刊：
影响因子：
23.4
通讯作者：
Gettman, Matthew T.
中科院分区：
文献类型：
--
作者：
Viers, Boyd R.;Lightner, Deborah J.;Gettman, Matthew T.
背景：远程医疗在非卧床外科人群中的应用仍未得到完全评估。目的：比较视频访问(VV)技术和传统的办公室访问(OVS)技术在门诊就诊中的患者接触情况。设计、设置和参与者：从2013年6月到2014年3月，55名有前列腺癌病史的预先筛查的男性患者被前瞻性随机抽取。与患者在家或工作的VV被包括在泌尿科医生的门诊日程表中。干预：远程VV与传统OV。结果测量和统计分析：使用等价性分析来评估主要结果，通过时间研究测量就诊效率。次要结果是患者/提供者的满意度和成本。结果和局限：有28个VV和27个OV。VVS的效率与OVS相同，通过患者-提供者面对时间(平均14.5vs14.3分钟；p=0.96)、患者等待时间(18.4vs13.0分钟；p=0.20)和用于护理的总时间(17.9vs17.8min；p=0.97)来衡量。患者对访问的保密性、效率、教育质量或总体满意度的感知没有显著差异。VVS产生的成本较低，包括旅行距离(中位数为0比95英里)、旅行时间(0比95分钟)、误工(0比1天)和旅行花费(0美元比48美元；均为P<；0.0001)。泌尿科医生对VVS(88%)和OVS(90%)的满意度都很高。主要的限制是样本量。结论：在非卧床前列腺摘除术后环境中的VV可能在未来的卫生保健提供模式中发挥作用。我们发现，与OV相比，VV具有相同的效率、相似的满意度，但显著降低了患者成本。进一步的前瞻性分析是有必要的。患者总结：在接受手术治疗的男性前列腺癌患者中，我们评估了远程视频访问与门诊咨询泌尿科医生的办公室访问的实用性。与办公室就诊相比，视频就诊具有同等的效率、相似的满意度和显著降低的患者成本。我们的结论是，视频访问可能会在未来的医疗保健提供模式中发挥作用。(C)2015年欧洲泌尿外科协会。爱思唯尔出版，版权所有。
Background: Telemedicine in an ambulatory surgical population remains incompletely evaluated. Objective: To investigate patient encounters in the outpatient setting using video visit (VV) technology compared to traditional office visits (OVs).Design, setting, and participants: From June 2013 to March 2014, 55 prescreened men with a history of prostate cancer were prospectively randomized. VVs, with the patient at home or at work, were included in the outpatient clinic calendar of urologists.Intervention: Remote VV versus traditional OV.Outcome measurements and statistical analysis: An equivalence analysis was used to assess the primary outcome, visit efficiency as measured by time studies. Secondary outcomes were patient/provider satisfaction and costs.Results and limitations: There were 28 VVs and 27 OVs. VVs were equivalent in efficiency to relative to OVs, as measured by patient-provider face time (mean 14.5 vs 14.3 min; p = 0.96), patient wait time (18.4 vs 13.0 min; p = 0.20), and total time devoted to care (17.9 vs 17.8 min; p = 0.97). There were no significant differences in patient perception of visit confidentiality, efficiency, education quality, or overall satisfaction. VVs incurred lower costs, including distance traveled (median 0 vs 95 miles), travel time (0 vs 95 min), missed work (0 vs 1 d), and money spent on travel ($0 vs $48; all p < 0.0001). There was a high level of urologist satisfaction for both VVs (88%) and OVs (90%). The major limitation was sample size.Conclusions: VV in the ambulatory postprostatectomy setting may have a future role in health care delivery models. We found equivalent efficiency, similar satisfaction, but significantly reduced patient costs for VV compared to OV. Further prospective analyses are warranted.Patient summary: Among men with surgically treated prostate cancer, we evaluated the utility of remote video visits compared to office visits for outpatient consultation with a urologist. Video visits were associated with equivalent efficiency, similar satisfaction, and significantly lower patient costs when compared to office visits. We conclude that video visits may have a future role in health care delivery models. (C) 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.