Are Patients Satisfied With a Web-based Followup after Total Joint Arthroplasty?
Are Patients Satisfied With a Web-based Followup after Total Joint Arthroplasty?
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DOI：
10.1007/s11999-014-3514-0
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发表时间：
2014-06-01
影响因子：
4.2
通讯作者：
McAuley, James
中科院分区：
文献类型：
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作者：
Marsh, Jacquelyn;Bryant, Dianne;McAuley, James
基于网络的随访评估可能是跟踪全关节置换术后患者预后的一种可行且节省成本的替代方法。然而，在实施基于网络的计划之前，确定患者对新随访方法的满意度是很重要的。对所接受治疗的满意度正在成为越来越重要的衡量标准，我们不知道患者对不涉及与外科医生亲自访问的随访方法的满意程度。我们确定(1)患者满意度和(2)患者对全关节置换术后随访方法的偏好（网络或面对面）。我们随机选择在原发性全髋关节置换术或全髋关节置换术后至少12个月的患者，让他们完成基于网络的随访或在诊所预约。在招募期间，有410名符合条件的患者参与了这项研究。其中，256名患者同意参与，总共229名患者完成了研究（89%的参与者，56%的潜在合格患者；111名在常规护理组，118名在网络组）。平均年龄69岁（38-86岁）。两组之间没有交叉。所有229名患者在随访时都完成了满意度调查问卷。网络组患者在1年后还完成了满意度和偏好问卷。只有来自网络组的患者被要求表明偏好，因为他们经历了网络和面对面的随访方法。我们采用描述性统计对满意度问卷进行汇总，并采用Pearson卡方检验对结果进行比较。常规护理组有91例患者（82.0%）表示对随访过程非常满意或非常满意，而网络护理组有90例患者（75.6%）表示对随访过程非常满意（p < 0.01；优势比[or] = 3.95; 95% CI, 1.79 ~ 8.76）。同样，与网络组相比，常规护理组的患者对外科医生的护理更满意（92.8%对73.9%;p < 0.01, OR = 1.37; 95% CI, 0.73-2.57）。44%的患者选择基于网络的方法，36%的患者选择常规方法，16%的患者没有选择（p = 0.01）。我们的结果显示，在基于网络的随访评估中，满意度中等至较高。完成通常的面对面随访评估方法的患者满意度更高；然而，这种差异很小，可能不会超过基于网络的随访方法的额外成本和节省时间的好处。
A web-based followup assessment may be a feasible, cost-saving alternative of tracking patient outcomes after total joint arthroplasty. However, before implementing a web-based program, it is important to determine patient satisfaction levels with the new followup method. Satisfaction with the care received is becoming an increasingly important metric, and we do not know to what degree patients are satisfied with an approach to followup that does not involve an in-person visit with their surgeons.We determined (1) patient satisfaction and (2) patients' preferences for followup method (web-based or in-person) after total joint arthroplasty.We randomized patients who were at least 12 months after primary THA or TKA to complete a web-based followup or to have their appointment at the clinic. There were 410 eligible patients contacted for the study during the recruitment period. Of these, 256 agreed to participate, and a total of 229 patients completed the study (89% of those enrolled, 56% of those potentially eligible; 111 in the usual-care group, 118 in the web-based group). Their mean age was 69 years (range, 38-86 years). There was no crossover between groups. All 229 patients completed a satisfaction questionnaire at the time of their followup appointments. Patients in the web-based group also completed a satisfaction and preference questionnaire 1 year later. Only patients from the web-based group were asked to indicate preference as they had experienced the web-based and in-person followup methods. We used descriptive statistics to summarize the satisfaction questionnaires and compared results using Pearson's chi-square test.Ninety-one patients (82.0%) in the usual-care group indicated that they were either extremely or very satisfied with the followup process compared with 90 patients (75.6%) who were in the web-based group (p < 0.01; odds ratio [OR] = 3.95; 95% CI, 1.79-8.76). Similarly, patients in the usual care group were more satisfied with the care they received from their surgeon, compared with patients in the web-based group (92.8% versus 73.9%; p < 0.01, OR = 1.37; 95% CI, 0.73-2.57). Forty-four percent of patients preferred the web-based method, 36% preferred the usual method, and 16% had no preference (p = 0.01).Our results show moderate to high satisfaction levels with a web-based followup assessment. Patients who completed the usual method of in-person followup assessment reported greater satisfaction; however, the difference was small and may not outweigh the additional cost and time-saving benefits of the web-based followup method.