ABSTRACT
INTRODUCTION AND OBJECTIVE: Infection control practices and public policy in response to the COVID-19 pandemic shifted healthcare practices towards a telemedicine format. Even two years after peak onset of the pandemic, many clinics, including our own institution, maintain a working telehealth option for patient visits, with some patients even preferring this modality of care delivery. Our objective was to evaluate patient utilization of telehealth visits versus inperson visits at our institution and whether this was impacted by demographics, medical history, and socioeconomic factors. METHOD(S): Medical Record Numbers for all patients with bladder cancer were pulled via accessible billing-level data from the period 7/1/2019-2/28/2022. Chart review was conducted to pull clinical data on patients including telehealth versus in person visits, demographic data, clinical stage, comorbidities (diabetes, smoking status, BMI), rural/urban status by zip code (>50,000, <50,000 individuals) and income levels by zip code (25K-49.9K, 50K-99.9K, <100K), payor status, patient distance, and gas savings/carbon footprint. RESULT(S): 430 patients completed in person visits while 268 completed telehealth visits. There was no statistically significant difference for in person visits vs. telehealth visits regarding patients' race (p=0.541), ethnicity (p=0.394) age (p=0.862), urban/rural status (p=0.507), payor status (p=0.127), mean zip code income (p=0.175), and comorbidities (p=0.626 for diabetes, p=0.706 for smoking, p=0.459 for BMI), and clinical stage (p=0.07). There was a statistically significant difference in mean distance (14.85 miles versus 26.86 miles, p<0.01). CONCLUSION(S): Post-pandemic, telehealth usage and acceptability among patients with bladder cancer remains high. Patients' with bladder cancer receive care from their urologist via in person visits versus telehealth at similar rates irrespective of their urban/rural status, demographics, payor status, relevant comorbidities, or relative income. Patients are more likely to engage in care with their urologist via telehealth if they live farther from a large urban academic center, which produces an economical and environmental impact via gas/time savings and reduced carbon footprint.
ABSTRACT
Introduction &Objective: Burnout continues to increase in the healthcare field, particularly amongst our trainees, yet there is no 'gold standard' for preventing burnout or promoting wellness. Given reports on the impact of the COVID-19 pandemic on mental health combined with increased calls by institutional leadership to prevent burnout amongst healthcare workers, our objective was to assess wellness initiatives and burnout levels amongst trainees at the start and two years into the pandemic. Method(s): This was a prospective survey distributed to medical students and residents at two timepoints: (1) Peak onset of the COVID-10 pandemic (April-May 2020, N = 121) and two years later following vaccine availability and reductions in social distancing precautions (March 2022, N = 77). Trainees provided demographic information and described wellness or burnout prevention initiatives currently available to them. They also took two standardized assessments (Maslach Burnout Inventory, Perceived Stress Scale). Result(s): Satisfaction with burnout mitigation education appears in Figure 1. Trainees were only slightly satisfied with their current ability to reduce wellness and mitigate burnout, as well as with the education or training currently provided to them (ps <0.05). Over the two-year pandemic, trainees reported that the amount of wellness education provided by their program formally had increased (p < 0.01) but remained very low (p < 0.001). Trainees also reported less ability to fulfil work requirements without compromising their own health and wellness (p < 0.001). Although levels of burnout (MBI) and stress (PSS) did not differ across training level (p > 0.1), scores on the MBI were significantly related to perceived need for additional wellness education and training (ps <0.05). Conclusion(s): Even following calls from leadership to increase burnout mitigation for healthcare workers, trainees are still not satisfied with the amount of education and training related to burnout mitigation and think more is needed to succeed in their current and post-graduation careers, with those experiencing higher burnout reporting this more strongly. These results suggest the need for formalized wellness and burnout mitigation education.