ABSTRACT
INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic initiated rapid widespread utilization of telemedicine affecting all health care providers, including those in pediatric urology. Understanding the factors of patient and parent satisfaction can aid in health care delivery. The aim of this study was to identify key indicators of patient and parent satisfaction with pediatric urology telemedicine visits. METHOD(S): We conducted a prospective cross-sectional survey of all patients evaluated with a telehealth visit from October 2021 - April 2022. We included all consecutive patients aged 0-18 years who received an outpatient pediatric urology telehealth visit. All patients received an 8-question patient/parent reported outcome (PRO) survey via email within 30 days of the visit, including 5 satisfaction questions regarding various aspects of telemedicine rated on a scale of 1-5. Statistical analysis was performed using Pearson correlation, Mann- Whitney U, and Chi Squared tests, with p<0.05 considered significant. RESULT(S): A total of 1213 patients completed a telehealth visit, of which 83 (7%) completed the PRO survey. Visit type included 40 (48%) post-operative, 29 (35%) follow-up, and 14 (17%) new consults. From the survey responses, 84% reported time savings, 31% reported money savings, 30% avoided time away from work, and 27% of children avoided missing school. No technical issues were experienced in 86% of the visits. Satisfaction with telehealth was highest for the post-operative patient, 4.8/5 after orchiopexy and 4.4/5 after circumcision. Patients saved a median travel distance of 22 miles [IQR: 15-41]. Patients living farther than 22 miles had higher satisfaction scores in terms of simplicity and preference to in-person visits compared to those who lived closer (p=0.019). Patients living in zip codes below the median household income had significantly higher satisfaction scores (p =0.032). Patients with public health insurance had significantly higher overall satisfaction scores compared to those with private health insurance (p=0.022). There was no difference in satisfaction based on parent age or whether the patient was evaluated for a new, follow-up, or post-operative video visit. CONCLUSION(S): Children and their caregivers were satisfied with pediatric urology telehealth visits when seen as a new, follow-up, or post-operative patient. Indicators for satisfaction may include long travel distance to the clinic, lower than median household income zip codes, and public health insurance. Appropriate use of telehealth may provide better access to care and optimize healthcare delivery.
ABSTRACT
Purpose of Study: We hypothesize that patient and parent satisfaction of telemedicine is influenced by patient key indicators. By delineating these key indicators, we can strategically utilize video visits in a way that maximizes patient satisfaction, while maintaining high quality care. The aim of this study is to reveal which key indicators are predictive of patient and parent satisfaction with video visits. Methods Used: We performed a retrospective review of all patients and parents who were evaluated via video visit for Loma Linda University Pediatric Urology from October 2021 - April 2022. All patients received an 8-question validated satisfaction survey via email within 30 days of the visit. Patient demographics, clinical data, and survey responses were collected. We analyzed all patients who completed a telemedicine visit and the post-visit survey. Exclusion criteria included incomplete survey responses. Primary outcomes include high satisfaction scores on survey questions. Univariate analysis was conducted for indicators of patient and parent satisfaction using Pearson correlation, Mann-Whitney U, and Chi Squared, with clinical significance defined as p value < 0.05 using SPSS. Summary of Results: A total of 1213 patients had video visits from October 2021 - April 2022. Of those who completed a video visit, 83 patients (7%) completed the satisfaction survey. Of those who completed the survey, 40 (48%) were post-operative visits, 29 (35%) were follow-up visits, and 14 (17%) were new visits. Families said telemedicine saved them time (84%), saved them money (31%), allowed them to avoid time away from work (30%), allowed their child to avoid missing school (27%), and that they did not experience any technical issues (86%). Mean overall satisfaction score (1-5) was 4.36 for post-op circumcision patients and 4.80 for post-op orchiopexy patients. Median travel distance saved by performing a video visit was 22 miles (IQR 15 - 41 miles). Compared to those who lived closer, patients who lived farther than 22 miles from the clinic had significantly higher satisfaction scores for Q3 (p < 0.019) and Q4 (p < 0.049) [reference Table]. Compared to higher household incomes based on zip code, patients with lower than median household income of $64,384 had significantly higher satisfaction scores for Q1 (p < 0.032), Q3 (p < 0.039), and Q4 (p < 0.040). Patients with public insurance had significantly higher satisfaction scores compared to those with private insurance for Q1 (4.68 vs 4.15, p < 0.022), Q2 (4.90 vs 4.64, p < 0.018), and Q3 (4.82 vs 4.58, p < 0.050). Median parent age was 40 (IQR 32.4 - 42.2 years). There was no difference in satisfaction based on visit type or parent age. Conclusion(s): Overall, patients and parents in pediatric urology are satisfied with video visits across visit type and diagnosis. Patients who live farther away from the office, live in zip codes with lower median household incomes, or have public insurance seem to be more satisfied with video visits. (Table Presented).