背景:在COVID-19期间向远程医疗的必要过渡给提供者和患者带来了新的挑战,有机会加剧或减轻常设护理不平等。为了更好地了解泌尿外科中的虚拟医学护理,我们试图确定与完成预约和使用电话或视频访问相关的因素。
方法:我们进行了回顾性研究,从2020年3月17日至2020年8月31日对所有远程患者预约进行单机构横截面分析。主要结果是预约完成率。如果患者取消预约,他们被确定没有完成预约,在被看到之前离开了,或者是一个“没有表演”。“次要分析评估了与安排视频和电话预约相关的因素。分析了各种患者和预约特定因素。相应地使用卡方检验和单变量逻辑回归进行分析。
结果:在3,769个任命中,完成2,996(79.5%),而未完成773(20.5%),1,544(41.0%)通过电话完成,而2,225(59.0%)使用视频。种族,年龄,收入,保险,location,划分和预约时间对预约完成和就诊方式有统计学意义(p<0.05)。女性更有可能使用视频(62.7%对58.0%,p=0.01)。患者更有可能完成下午就诊(81.1%vs78.3%,p=0.04),医生访视(81.2%vs75.4%,p<0.01)和电话(83.3%对76.9%,p<0.01)。
结论:多个因素与预约完成率和电话或视频的使用相关。这些因素可能反映了健康的社会决定因素的差异,选择的患者可能会受益于额外的护理协调,以防止错过预约和解构不平等。
BACKGROUND: The necessary transition to telehealth during COVID-19 generated new challenges for providers and patients, with the opportunity to exacerbate or mitigate standing care inequities. To better understand virtual medicine care delivery in urology, we sought to identify factors associated with appointment completion and use of telephone or video visits.
METHODS: We performed a retrospective, single-institutional cross-sectional analysis of all remote patient appointments from March 17, 2020-August 31, 2020. The primary outcome was appointment completion rate. Patients were determined to have not completed an appointment if they canceled, left before being seen or were a \"no show.\" Secondary analysis evaluated factors associated with scheduling video vs telephone appointment. Various patient and appointment-specific factors were analyzed. Chi-squared tests and univariate logistic regression were used for analysis accordingly.
RESULTS: Of 3,769 appointments, 2,996 (79.5%) were completed while 773 (20.5%) were not, with 1,544 (41.0%) completed over telephone while 2,225 (59.0%) used video. Race, age, income, insurance, location, division and appointment length showed statistical significance (p <0.05) for appointment completion and visit modality. Females were more likely to use video (62.7% vs 58.0%, p=0.01). Patients were more likely to complete afternoon visits (81.1% vs 78.3%, p=0.04), visits with physicians (81.2% vs 75.4%, p <0.01) and phone calls (83.3% vs 76.9%, p <0.01).
CONCLUSIONS: Multiple factors were associated with both appointment completion rate and use of telephone or video. These factors may reflect disparities in social determinants of health and select patients may benefit from additional coordination of care to prevent missed appointments and deconstruct inequities.