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1.
N Z Med J ; 135(1562): 63-77, 2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2147674

ABSTRACT

AIMS: Diabetes in pregnancy (DiP) rates are increasing worldwide. Pasifika, Indian and Maori peoples have high rates of DiP any improvements in clinical care may be beneficial for these populations. During COVID-19 lockdowns, the DiP service in Counties Manukau Health (CMH) South Auckland switched from face-to-face appointments to teleclinics. This study aims to: determine satisfaction of pregnant people with teleclinics for DiP; compare clinical outcomes and attendance for those receiving care through teleclinics versus standard care; and compare rates of clinic attendance between face-to-face and teleclinic appointments. METHODS: A standardised questionnaire was completed by those who had attended a teleclinic. The primary outcome was a high score (4-5/5) for satisfaction and future use. A separate, retrospective study of clinical outcomes, and the number of appointments scheduled/attended were compared between all DiP patients who were scheduled an appointment during lockdown, and all of those who were scheduled appointments the year prior. RESULTS: Of the thirty-five participants who completed the survey (response rate 37%), 89% scored the clinic highly for satisfaction and future use. There were 179 patients scheduled to clinic during the period where teleclinics were the default model of care, and 187 patients scheduled to clinic the year prior. No differences in clinical outcomes were observed. Those receiving care during lockdown were offered more appointments, although attendance rates did not differ. CONCLUSION: Teleclinics for DiP are acceptable to the people we surveyed, but should be developed further so they better support the needs of those using them.


Subject(s)
COVID-19 , Diabetes Mellitus , Appointments and Schedules , Communicable Disease Control , Female , Humans , New Zealand/epidemiology , Personal Satisfaction , Pregnancy , Pregnancy Outcome , Retrospective Studies
2.
Am J Public Health ; 112(S3): S284-S287, 2022 06.
Article in English | MEDLINE | ID: covidwho-2054651

ABSTRACT

Federally Qualified Health Centers (FQHCs) are organizations that provide primary care services to our nation's most vulnerable communities. This nurse practitioner-led intervention sought to double the number of available COVID-19 evaluation and testing appointments within an FQHC. Results showed a significant increase in the availability of respiratory clinic appointments, the number of completed appointments, and the number of tests completed. This demonstrates nurse practitioners' ability to work with organizations to develop innovative systems that can be adapted for future use. (Am J Public Health. 2022;112(S3):S284-S287. https://doi.org/10.2105/AJPH.2022.306827).


Subject(s)
COVID-19 , Ambulatory Care Facilities , Appointments and Schedules , COVID-19/diagnosis , COVID-19/epidemiology , Health Services Accessibility , Humans
3.
PLoS One ; 17(10): e0274190, 2022.
Article in English | MEDLINE | ID: covidwho-2054337

ABSTRACT

BACKGROUND: COVID-19 had affected the health-care-seeking behavior of people with chronic medical conditions. The impact is even worse in resource-limited settings like Ethiopia. Therefore, this study was aimed to assess the extent and correlates of missed appointments among adults with chronic disease conditions before and during the COVID-19 pandemic in the Northwest Ethiopia. METHODS: A retrospective chart review and cross-sectional survey were conducted from December 2020 to February 2021. A total of 1833 patients with common chronic disease were included by using a stratified systematic random sampling technique. Web-based data collection was done using Kobo collect. The data were explored using descriptive statistical techniques, the rate of missed appointments s before and during the COVID-19 pandemic was determined. A negative binomial regression model was fitted to identify the factors of missed appointment. An incidence rate ratio with its 95% confidence interval (CI) and p-value of the final model were reported. RESULTS: The rate of missed appointments was 12.5% (95% CI: 11.13%, 14.20%) before the pandemic, increased to 26.8% (95% CI: 24.73%, 28.82%) during the pandemic (p-value < 0.001). Fear of COVID-19 infection and lack of transport was the most common reasons for missing appointments. Older patients (Adjusted Incidence Rate Ratio (AIRR) = 1.01, 95% CI: 1.001; 1.015), having treatment follow up more than 5 years (AIRR = 1.36, 95%CI: 1.103; 1.69), shorter frequency of follow-up (AIRR = 2.22, 95% CI: 1.63; 2.49), covering expense out of pocket (AIRR = 2.26, 95%CI: 1.41; 2.95), having a sedentary lifestyle (AIRR = 1.36, 95%CI: 1.12; 1.71), and history of missed appointments before COVID-19 pandemic (AIRR = 4.27, 95%CI: 3.35; 5.43) were positively associated with the incidence of missed appointments. CONCLUSION: The rate of missed appointment increased significantly during the COVID-19 pandemic. Older age, longer duration of follow up, more frequent follow-up, out-of-pocket expenditure for health service, history of poor follow-up, and sedentary lifestyle had positive relationship with missed appointments during the pandemic. Therefore, it is important to give special emphasis to individuals with these risk factors while designing and implementing policies and strategies for peoples with chronic diseases to ensure the continuity of care and to avoid the long-term impact on their health.


Subject(s)
COVID-19 , Adult , Appointments and Schedules , COVID-19/epidemiology , Chronic Disease , Cross-Sectional Studies , Ethiopia/epidemiology , Humans , Pandemics , Retrospective Studies
4.
Am J Audiol ; 31(3S): 864-875, 2022 Sep 21.
Article in English | MEDLINE | ID: covidwho-2050580

ABSTRACT

BACKGROUND: Children with hearing loss and their families face many financial and logistical barriers to accessing audiological care. At Rush University's Student Community Outreach Program of Excellence (SCOPE), a pediatric hearing loss outreach program is under development to address and overcome those barriers through in-person hearing aid fittings and virtual follow-up appointments. OBJECTIVES: The goal of this clinical focus article was to develop a proposed protocol for SCOPE's pediatric hearing loss outreach program that would detail the use of a bimodal model of service delivery for pediatric amplification services. This clinical focus article provides a general description of the proposed protocol. METHOD: The proposed protocol was developed as a guideline for future service delivery within SCOPE's pediatric hearing loss outreach program. Categories and details within the protocol were derived from previously published protocols and clinically relevant research. RESULTS: The final protocol is composed of six sections, which detail the rationale and target population, necessary equipment, procedures for in-person hearing aid fittings, procedures for virtual follow-ups, outcome measures, and schedule of appointments. DISCUSSION: On the national level, access to audiological care for pediatric patients and their families is restricted by both financial and logistical barriers. A telehealth model of service delivery has been shown to be effective in providing high-quality patient care while addressing these barriers. A clinical program using a bimodal model of service delivery will be implemented to address these barriers in Chicago, Illinois. Future investigation is required to monitor the efficacy of the program and develop program-specific materials.


Subject(s)
Audiology , Hearing Aids , Hearing Loss , Appointments and Schedules , Child , Follow-Up Studies , Hearing Loss/rehabilitation , Humans
5.
Soc Sci Med ; 309: 115248, 2022 09.
Article in English | MEDLINE | ID: covidwho-2036537

ABSTRACT

A nudge changes people's actions without removing their options or altering their incentives. During the COVID-19 vaccine rollout, the Swedish Region of Uppsala sent letters with pre-booked appointments to inhabitants aged 16-17 instead of opening up manual appointment booking. Using regional and municipal vaccination data, we document a higher vaccine uptake among 16- to 17-year-olds in Uppsala compared to untreated control regions (constructed using the synthetic control method as well as neighboring municipalities). The results highlight pre-booked appointments as a strategy for increasing vaccination rates in populations with low perceived risk.


Subject(s)
COVID-19 Vaccines , COVID-19 , Appointments and Schedules , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Humans , Sweden , Vaccination
6.
N Z Med J ; 135(1562): 63-77, 2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2034379

ABSTRACT

AIMS: Diabetes in pregnancy (DiP) rates are increasing worldwide. Pasifika, Indian and Maori peoples have high rates of DiP any improvements in clinical care may be beneficial for these populations. During COVID-19 lockdowns, the DiP service in Counties Manukau Health (CMH) South Auckland switched from face-to-face appointments to teleclinics. This study aims to: determine satisfaction of pregnant people with teleclinics for DiP; compare clinical outcomes and attendance for those receiving care through teleclinics versus standard care; and compare rates of clinic attendance between face-to-face and teleclinic appointments. METHODS: A standardised questionnaire was completed by those who had attended a teleclinic. The primary outcome was a high score (4-5/5) for satisfaction and future use. A separate, retrospective study of clinical outcomes, and the number of appointments scheduled/attended were compared between all DiP patients who were scheduled an appointment during lockdown, and all of those who were scheduled appointments the year prior. RESULTS: Of the thirty-five participants who completed the survey (response rate 37%), 89% scored the clinic highly for satisfaction and future use. There were 179 patients scheduled to clinic during the period where teleclinics were the default model of care, and 187 patients scheduled to clinic the year prior. No differences in clinical outcomes were observed. Those receiving care during lockdown were offered more appointments, although attendance rates did not differ. CONCLUSION: Teleclinics for DiP are acceptable to the people we surveyed, but should be developed further so they better support the needs of those using them.


Subject(s)
COVID-19 , Diabetes Mellitus , Appointments and Schedules , Communicable Disease Control , Female , Humans , New Zealand/epidemiology , Personal Satisfaction , Pregnancy , Pregnancy Outcome , Retrospective Studies
7.
Health Soc Care Community ; 30(5): e2255-e2263, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2001638

ABSTRACT

Patients who miss scheduled appointments reduce clinical productivity and delay access to care for other patients. Reminders have improved attendance for healthcare appointments previously, but it is not known if short message service (SMS) implementation reduces incidence of patients unable to attend (UTA) or who fail to attend (FTA) appointments in the public dental service. This paper studied the effectiveness of SMS reminders in increasing appointment attendance at outpatient public dental services in Queensland. Data were sourced from the adult service and the children and adolescent oral health service (CAOHS) at West Moreton Hospital and Health Service, a public dental service in Queensland. A total of 63,238 appointments pre-implementation of SMS reminders and 55,028 appointments post-implementation over a period of 2 years were analysed for rates of attendance, UTA and FTA. Characteristics of UTA and FTA appointments were analysed to identify factors that hindered improvement after implementation of reminders. For the CAOHS, the attendance rate decreased 4% (95% CI: 2%, 6%) following SMS implementation. The UTA rate also increased by 20% (95% CI: 15%, 25%). Following SMS implementation in the adult service, the attendance rate increased from 73.5 (95% CI: 72.6, 74.4) to 77.7 (95% CI: 76.6-78.8) per 100 appointments. The FTA rate post-implementation was 1.08 (95% CI: 1.00, 1.16) times that from pre-intervention, and the UTA rate decreased from 21.7 (95% CI: 21.2, 22.2) to 17.1 (95% CI: 16.6, 17.7) per 100 appointments. The SMS reminders had a mixed effect on the attendance, UTA and FTA rates for the CAOHS and adult services. Reminders reduced the rates of UTA for the CAOHS service and increased the rate of attendance for the adult service. There was an increase in the FTA rate for both services.


Subject(s)
Outpatients , Reminder Systems , Adolescent , Adult , Appointments and Schedules , Child , Dental Care , Humans , Patient Compliance , Retrospective Studies
9.
BMJ Open ; 12(8): e060961, 2022 08 08.
Article in English | MEDLINE | ID: covidwho-1986366

ABSTRACT

OBJECTIVES: To describe the impact of the COVID-19 pandemic on outpatient appointments for children and young people. SETTING: All National Health Service (public) hospitals in England. PARTICIPANTS: All people in England aged <25 years. OUTCOME MEASURES: Outpatient department attendance numbers, rates and modes (face to face vs telephone) by age group, sex and socioeconomic deprivation. RESULTS: Compared with the average for January 2017 to December 2019, there was a 3.8 million appointment shortfall (23.5%) for the under-25 population in England between March 2020 and February 2021, despite a total rise in phone appointments of 2.6 million during that time. This was true for each age group, sex and deprivation fifth, but there were smaller decreases in face to face and total appointments for babies under 1 year. For all ages combined, around one in six first and one in four follow-up appointments were by phone in the most recent period. The proportion of appointments attended was high, at over 95% for telephone and over 90% for face-to-face appointments for all ages. CONCLUSIONS: COVID-19 led to a dramatic fall in total outpatient appointments and a large rise in the proportion of those appointments conducted by telephone. The impact that this has had on patient outcomes is still unknown. The differential impact of COVID-19 on outpatient activity in different sociodemographic groups may also inform design of paediatric outpatient services in the post-COVID period.


Subject(s)
COVID-19 , Adolescent , Appointments and Schedules , COVID-19/epidemiology , Child , England/epidemiology , Humans , Outpatients , Pandemics , State Medicine
10.
BMC Oral Health ; 22(1): 284, 2022 Jul 12.
Article in English | MEDLINE | ID: covidwho-1928176

ABSTRACT

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) is rapidly changed medical habits, and dental clinics have been forced to adapt. This study explored the pandemic-induced changes in patient utilization of dental services to assist practitioners in responding efficiently to similar public crises as references in the future. METHODS: We retrospectively analyzed the correlation between patient profiles and dental visits attendance within 2 months before and during the outbreak. RESULTS: A total of 332 patients, 210 women and 122 men (total number of visits: 1068) were enrolled in this study. A significantly lower attendance rate was noted during the COVID-19 period (70.3%) than prior to the pandemic (83.4%). The rate of return visits for patients with a high education level during the COVID-19 period was significantly reduced from 96.5 to 93.1%. In addition, the number of days between two visits significantly increased during the pandemic. CONCLUSIONS: Our results indicate that, during the pandemic period, the attendance rates of return dental appointments decreased, and the rate of missed appointments for patients with a high educational levels was higher than that of patients with a low educational level. CLINICAL RELEVANCE: Preventive management of these patients who are easy to miss dental appointments may enable more effective use of medical resources.


Subject(s)
COVID-19 , Pandemics , Appointments and Schedules , Female , Humans , Male , Patient Compliance , Retrospective Studies
11.
Can J Surg ; 65(3): E382-E387, 2022.
Article in English | MEDLINE | ID: covidwho-1902661

ABSTRACT

BACKGROUND: Day-of surgery cancellation (DOSC) is considered to be a very inefficient use of hospital resources and results in emotional stress for the patient. To examine opportunities to minimize the incidence of preventable cancellations - an indicator of quality of care - we assessed the incidence of and reasons for DOSCs over 3 months among inpatients and outpatients at a trauma orthopedic service. METHODS: This was a prospective study of 2 cohorts of patients, inpatients and outpatients, scheduled for emergent orthopedic surgery at a Canadian tertiary level 1 trauma centre from Jan. 1 to Mar. 31, 2020. Patient demographic characteristics, injury characteristics, delays until surgery and reasons for DOSCs were recorded. RESULTS: A total of 185 patients (100 males and 85 females with a mean age of 54 yr) were included in the study. There were 98 outpatients and 87 inpatients. Seventy-five (40%) of the scheduled procedures in the outpatient group and 34 (30%) of those in the inpatient group were cancelled. In both groups, more than 85% of the cancellations were because of prioritization of a more urgent orthopedic or nonorthopedic surgical case. The average operative delay for the outpatient group was 11.4 days, compared to 3.8 days for the inpatient group (p < 0.001). CONCLUSION: High DOSC rates were observed among both outpatients and inpatients. The main reason for delaying surgery was prioritization of a more urgent surgical case. Providing the orthopedic trauma service with a dedicated OR opened 6 days per week, along with extended hours of OR services to 1700 daily, might be effective at minimizing DOSCs.


Subject(s)
Appointments and Schedules , Orthopedic Procedures , Canada , Female , Humans , Male , Middle Aged , Operating Rooms , Prospective Studies , Trauma Centers
12.
N Z Med J ; 135(1553): 72-82, 2022 04 14.
Article in English | MEDLINE | ID: covidwho-1898120

ABSTRACT

AIMS: To investigate the impact of clinician-led telephone consultation during the New Zealand COVID-19 lockdown on subsequent appointment attendance in a paediatric audiology service, particularly for Maori and Pacific families. METHODS: A retrospective clinical audit at Counties Manukau Health of all children (>3 years old) on the audiology waiting list. Binary logistic regression analysis tested for association of appointment attendance following attempted audiologist-led telephone consultation, with ethnicity, waiting times, socio-economic deprivation levels and telephone consultation contact. RESULTS: Of 349 eligible children, 208 families participated in telephone consultations (59%). Ten percent of those contacted were able to be discharged as no longer requiring care. There were no differences in attendance rates between those who had participated in telephone consultation and those who had not (77.5% versus 77.8%). Pacific and Maori children were 68% and 64% less likely to attend appointments after adjusting for socio-economic deprivation level, waiting time and telephone consultation compared to NZ European children. Longer waiting times were significantly associated with decreased attendance rates. CONCLUSIONS: Attendance was found to be associated with ethnicity and waiting times. Telephone consultation did not improve attendance rates overall nor for ethnicity subgroups. It is therefore concluded that telephone consultation was found to be of only limited benefit in paediatric audiology services.


Subject(s)
Audiology , COVID-19 , Ambulatory Care , Appointments and Schedules , COVID-19/epidemiology , Child , Child, Preschool , Communicable Disease Control , Humans , New Zealand , Referral and Consultation , Retrospective Studies , Telephone , Triage
13.
J Dtsch Dermatol Ges ; 20(7): 962-978, 2022 07.
Article in English | MEDLINE | ID: covidwho-1879014

ABSTRACT

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic poses a great challenge for cancer patients. Our aim was to assess its influence on treatment and appointments of melanoma patients after one year of pandemic. METHODS: Melanoma patients treated in the Vivantes Skin Cancer Centre in Berlin, Germany completed a postal survey on pandemic-related alterations in melanoma care. Impact factors on changes of appointments were examined with descriptive analyses and multivariate logistic regression. Data after one year of pandemic were compared to those after its first wave. RESULTS: Among 366 participants (57.7 % males; mean age 69.2 years, response rate: 36.1 %), 38 (10.1 %) reported postponed or missed appointments, mostly on their own demand (71.1 %) due to fear of COVID-19 (52.6 %). Current treatment was associated with a lower risk of changing appointments (Odds Ratio [OR]: 0.194, p = 0.002), higher age (OR: 1.037, p = 0.039), longer disease duration (OR: 1.007, p = 0.028), and higher school degree (OR: 2.263, p = 0.043) with higher probability. Among 177 patients currently receiving therapy, only 1.7 % experienced pandemic-related treatment alterations. Concern about COVID-19 was significantly higher after one year of pandemic than after its first wave, but the number of missed appointments was lower. CONCLUSIONS: Pandemic-related changes were rare in our cohort and decreased over time despite increasing concern.


Subject(s)
COVID-19 , Melanoma , Aged , Appointments and Schedules , Berlin/epidemiology , COVID-19/epidemiology , Female , Humans , Male , Melanoma/epidemiology , Melanoma/therapy , Pandemics
14.
J Med Imaging Radiat Oncol ; 66(6): 874-880, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1853543

ABSTRACT

INTRODUCTION: COVID-19 has impacted lives worldwide. Public health guidance has advocated for minimisation of infection risk by encouraging social isolation and physical distancing. In response, many health services have changed delivery practices to increased use of telehealth. We undertook an audit of hospital attendance data collected from a radiation oncology service in a large public hospital in Victoria, Australia between January and September in 2019, and the same period in 2020. The aim was to discern the impact of COVID-19 on attendance at appointments and whether attendance rates differed by appointment type. METHODS: Attendance data and appointment type for the two targeted periods (a total of 62,528 appointments for 3383 patients) were extracted from the database maintained by the radiation oncology service. Logistic generalised estimating equation (GEE) models were run with the final model including the COVID-19 period (pre, during) and all patient and appointment characteristics. RESULTS: Results indicated a small decrease in attendance in 2020 (OR = 1.13, 95% CI 1.01-1.25, P = 0.026) with this predominantly reported for the non-treatment appointments, which consisted of follow-up appointments, nurse appointments, and treatment review appointments. CONCLUSION: Attendance for radiation oncology treatment was largely unaffected by COVID-19 although other services experienced slight reductions. Changes to work practices, specifically the increased use of telehealth, may have moderated the impact. Given the focus on one service in one location, it is not possible to generalise these results and future research should closely monitor both patient and staff satisfaction with services delivered via modified processes.


Subject(s)
COVID-19 , Radiation Oncology , Appointments and Schedules , Hospitals, Public , Humans , Victoria/epidemiology
15.
J Digit Imaging ; 35(5): 1303-1307, 2022 10.
Article in English | MEDLINE | ID: covidwho-1844399

ABSTRACT

Guidelines for COVID-19 issued by the Centers for Disease Control and Prevention prompted state and local governments to mandate safety measures for screening high-risk patient populations and for institutions to look for ways to limit human contact when possible. The aim of this study was to determine the feasibility of an automated communication system (chatbot) for COVID-19 screening before patients' radiology appointments and to describe patient experiences with the chatbot. We developed a chatbot for COVID-19 screening before outpatient radiology examination appointments and tested it in a pilot study from July 6 to August 31, 2020. The chatbot assessed the presence of any symptoms, exposure, and recent testing. User experience was assessed via a questionnaire based on a 5-point Likert scale. Multivariable logistic regression was performed to predict response rate. The chatbot COVID-19 screening SMS message was sent to 4687 patients. Of these patients, 2722 (58.1%) responded. Of the respondents, 46 (1.7%) reported COVID-19 symptoms; 34 (1.2%) had COVID-19 tests scheduled or pending. Of the 1965 nonresponders, authentication failed for 174 (8.8%), 1496 (76.1%) did not engage with the SMS message, and 251 (12.8%) timed out of the chatbot. The mean rating for the chatbot experience was 4.6. In a multivariable logistic regression model predicting response rate, English written-language preference independently predicted response (odds ratio, 2.71 [95% CI, 1.77-2.77]; P = .007). Age (P = 0.57) and sex (P = 0.51) did not predict response rate. SMS-based COVID-19 screening before scheduled radiology appointments was feasible. English written-language preference (not age or sex) was associated with higher response rate.


Subject(s)
COVID-19 , Radiology , Humans , COVID-19/epidemiology , Pilot Projects , Appointments and Schedules , Surveys and Questionnaires
17.
J Int AIDS Soc ; 25(3): e25887, 2022 03.
Article in English | MEDLINE | ID: covidwho-1797859

ABSTRACT

INTRODUCTION: The PROMISE study was launched in 2018 to assess and document the implementation of changes to an existing HIV Care Coordination Programme (CCP) designed to address persistent disparities in care and treatment engagement among persons with HIV in New York City. We evaluated provider endorsement of features of the CCP to understand drivers of engagement with the programme. METHODS: We used a discrete choice experiment to measure provider endorsement of four CCP attributes, including: (1) how CCP helps with medication adherence, (2) how CCP helps with primary care appointments, (3) how CCP helps with issues other than primary care and (4) where CCP visits take place (visit location). Each attribute had three to four levels. Our primary outcomes were relative importance and part-worth utilities, measures of preference for the levels of the four CCP program attributes, estimated using a hierarchical-Bayesian multinomial logit model. All non-medical providers in the core CCP positions of patient navigator, care coordinator and programme director or other administrator from each of the 25 revised CCP-implementing agencies were eligible to participate. RESULTS: We received responses from 152 providers, 68% of whom identified as women, 49% identified as Latino/a, 34% identified as Black and 60% were 30-49 years old. Visit location (28.6%, 95% confidence interval [CI] 27.0-30.3%) had the highest relative importance, followed by how staff help with ART adherence (24.3%, 95% CI 22.4-26.1%), how staff help with issues other than primary care (24.2%, 95% CI 22.7-25.7%) and how staff help with primary care appointments (22.9%, 95% CI 21.7-24.1%). Within each of the above attributes, respectively, the levels with the highest part-worth utilities were home visits 60 minutes from the program or agency (utility 19.9, 95% CI 10.7-29.0), directly observed therapy (utility 26.1, 95% CI 19.1-33.1), help with non-HIV specialty medical care (utility 26.5, 95% CI 21.5-31.6) and reminding clients about and accompanying them to primary care appointments (utility 20.8, 95% CI 15.6-26.0). CONCLUSIONS: Ongoing CCP refinements should account for how best to support and evaluate the intensive CCP components endorsed by providers in this study.


Subject(s)
HIV Infections , Adult , Appointments and Schedules , Bayes Theorem , Female , HIV Infections/drug therapy , Humans , Medication Adherence , Middle Aged , New York City
18.
J Orthod ; 49(3): 288-295, 2022 09.
Article in English | MEDLINE | ID: covidwho-1759643

ABSTRACT

OBJECTIVE: To create a COVID-19 information checklist and critique all available webpages of hospitals with an orthodontic department in England. DESIGN: Cross-sectional analysis. SETTING: World Wide Web. METHODS: A 16-item COVID-19 webpage checklist was developed using up-to-date COVID-19 government advice, and the General Dental Council Principles of Ethical Advertising. Presence of advice on managing orthodontic appliance breakages, information on outpatient appointment changes and video consultations was also assessed. The checklist was used to undertake a cross-sectional analysis of all available webpages of hospitals with an orthodontic department in England between September 2020 to October 2020. RESULTS: A total of 61 webpages were assessed. Of them, 95% had a COVID-19 section on the homepage, including advice on the use of face coverings during hospital visits. Only 18% of websites provided information on orthodontic appliance care and breakages. Four orthodontic department websites stated the department was closed during this study. The mean update interval of the webpages was six weeks (range = 1-28 weeks). Only one webpage fully conformed with the COVID-19 checklist. CONCLUSION: Availability and completeness of COVID-19 information on webpages of hospitals with an orthodontic department varied, which may be due to the absence of a formal COVID-19 information webpage checklist. The checklist produced in this research may prove valuable to encourage uniform patient support and positive patient experience across orthodontic services. Principles behind the development of the checklist could be adopted during prolonged service disruptions to ensure optimal patient communications. The checklist is equally applicable to primary and secondary care settings.


Subject(s)
COVID-19 , Appointments and Schedules , Checklist , Communication , Cross-Sectional Studies , Humans
19.
Acad Pediatr ; 22(8): 1375-1383, 2022.
Article in English | MEDLINE | ID: covidwho-1748348

ABSTRACT

OBJECTIVE: The COVID-19 pandemic prompted health systems to rapidly adopt telehealth for clinical care. We examined the impact of demography, subspecialty characteristics, and broadband availability on the utilization of telehealth in pediatric populations before and after the early period of the COVID-19 pandemic. METHODS: Outpatients scheduled for subspecialty visits at sites affiliated with a single quaternary academic medical center between March-June 2019 and March-June 2020 were included. The contribution of demographic, socioeconomic, and broadband availability to visit completion and telehealth utilization were examined in multivariable regression analyses. RESULTS: Among visits scheduled in 2020 compared to 2019, in-person visits fell from 23,318 to 11,209, while telehealth visits increased from 150 to 7,675. Visits among established patients fell by 15% and new patients by 36% (P < .0001). Multivariable analysis revealed that completed visits were reduced for Hispanic patients and those with reduced broadband; high income, private non-HMO insurance, and those requesting an interpreter were more likely to complete visits. Those with visits scheduled in 2020, established patients, those with reduced broadband, and patients older than 1 year were more likely to complete TH appointments. Cardiology, oncology, and pulmonology patients were less likely to complete scheduled TH appointments. CONCLUSIONS: Following COVID-19 onset, outpatient pediatric subspecialty visits shifted rapidly to telehealth. However, the impact of this shift on social disparities in outpatient utilization was mixed with variation among subspecialties. A growing reliance on telehealth will necessitate insights from other healthcare settings serving populations of diverse social and technological character.


Subject(s)
COVID-19 , Telemedicine , Humans , Child , Pandemics , Outpatients , Appointments and Schedules
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