Barriers associated with failed completion of an acute care general surgery telehealth clinic visit
Barriers associated with failed completion of an acute care general surgery telehealth clinic visit
复制标题
DOI：
10.1016/j.surg.2020.06.029
复制
发表时间：
2020-11-01
期刊：
影响因子：
3.8
通讯作者：
Alam, Hasan B.
中科院分区：
文献类型：
--
作者：
Kemp, Michael T.;Williams, Aaron M.;Alam, Hasan B.
背景资料：作为远程保健的一种形式，外科电子诊所（电子诊所、视频或电话就诊）是提供护理的一种安全有效的方式;然而，导致诊所利用率低下的因素没有得到很好的描述。进行这项研究，以收集电子诊所利用数据，并更好地定义障碍，以访问completen.Methods：回顾性分析了199例患者照顾的普通外科服务，随后转介到电子诊所（2019年1月至2019年6月）进行。收集有关人口统计学、医学特征、旅行距离和术后并发症的数据。根据访视完成情况对患者进行分类。适当时进行卡方（2）和Fisher精确分析。对取消的原因进行了分类。结果：超过1/5的患者（21.6%）未能完成就诊。根据手术类型、美国麻醉医师协会分类和年龄，未观察到完成率差异。未完成组中非白种人患者和婚姻状况为单身的患者比例显著较高（P <0.05）。旅行距离没有影响。并发症发生率低。30天内的临床前再入院导致完成失败。取消的原因包括医疗问题，技术上的困难，和患者的喜好，没有后续的电子clinic.Conclusion：几个因素导致患者的失败，以完成电子诊所的访问，包括婚姻状况，医疗并发症，技术问题，和患者的喜好。电子诊所的使用模式也显示出种族差异。成功的电子诊所计划的实施需要了解的因素，有助于失败的访问，以解决这些问题，并提高访问。(C)2020爱思唯尔公司All rights reserved.
Background: A form of telehealth, a surgical electronic clinic (E-clinic, video or telephone visit) is a safe and efficient way for delivering care; however, factors leading to poor clinic utilization are not well-described. This study was performed to gather electronic clinic utilization data and to better define barriers to visit completion.Methods: A retrospective review of 199 patients cared for by a general surgery service with subsequent referral to the electronic clinic (January 2019 to June 2019) was performed. Data regarding demographics, medical characteristics, travel distance, and postoperative complications were collected. Patients were categorized based upon visit completion. The chi(2) and Fisher exact analyses were performed as appropriate. Reasons for cancellations were categorized.Results: More than 1/5 of all patients (21.6%) failed to complete the visit. No differences were observed in completion rates according to the type of operation, American Society of Anesthesiologists classification, and age. The failed-completion group had a significantly (P < .05) higher proportion of non-Caucasian patients and those with a marital status of single. Travel distance had no impact. Complication rates were low. Preclinic readmission within 30 days contributed to failed completion. Reasons for cancellation included medical issues, technical difficulties, and patient preference to have no follow-up in the electronic clinic.Conclusion: Several factors contribute to a patient's failure to complete an electronic clinic visit including marital status, medical complications, technical issues, and patient preference. Electronic clinic utilization patterns also demonstrate racial disparities. Successful electronic clinic program implementation requires understanding the factors that contribute to failed visits to address them and improve access. (C) 2020 Elsevier Inc. All rights reserved.