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1.
Eur J Med Res ; 27(1): 3, 2022 Jan 11.
Article in English | MEDLINE | ID: covidwho-1622261

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) as an infectious disease primarily spreading through droplet infection in dental treatment. Patient satisfaction is an indicator of healthcare quality service. Quality of healthcare service and patient satisfaction has been affected by the COVID­19 pandemic. This study aims to assess the knowledge and satisfaction toward health protocols COVID-19 during dental treatment among dental patients. METHODS: An institutional-based cross-sectional study was conducted on 270 dental patients using a self­designed questionnaire consisting of knowledge and satisfaction about health protocols COVID-19 during dental treatment through a random sampling technique. Data were imported to SPSS version 21 for analysis. Descriptive and analytical statistics were used to identify the factors associated with their knowledge and satisfaction. A p value < 0.05 was considered statistical significance. RESULTS: Totally, 270 dental patients with mean age of 37.6 ± 6.7 years participated in the study. The mean knowledge score was 36.7 ± 3.5, as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. The overall level of patient satisfaction was 44.6%. CONCLUSION: It can be concluded that, public knowledge is to be improved about risk of virus transmission that can be related with dental treatment and also people should be encouraged to use virtual facilities, such as teledentistry, so that no dental emergencies is left untreated during the pandemic time. In addition, the level of satisfaction was in a medium level for dental patients in the study area. Specifically, we deduced from the results that social/physical distancing measures are one of the mechanisms to decrease the fear of exposure to the COVID-19.


Subject(s)
COVID-19/prevention & control , Dental Care/statistics & numerical data , Knowledge , Patient Satisfaction/statistics & numerical data , Surveys and Questionnaires , Adolescent , Adult , COVID-19/transmission , COVID-19/virology , Chi-Square Distribution , Cross-Sectional Studies , Dental Care/methods , Dental Care/standards , Female , Humans , Male , Middle Aged , SARS-CoV-2/physiology , Young Adult
2.
J Cancer Res Ther ; 17(6): 1540-1546, 2021.
Article in English | MEDLINE | ID: covidwho-1597096

ABSTRACT

Purpose: Coronavirus disease (COVID-19) pandemic has affected the entire health-care system and has led to a sense of fear and anxiety in the minds of patients. Patient's perceptions in this scenario of the pandemic are unknown. Providing continued care for cancer patients during the lockdown has been challenging. Measures are needed to improve patient safety and satisfaction during these challenging times and hence the importance of measuring the degree of satisfaction for the quality of care provided. The aim of the study was to evaluate the factors related to patients' satisfaction and also understand their apprehensions, fears, and anxieties they face as they receive radiotherapy treatment amid COVID-19 pandemic. The study's objective was to explore other aspects such as logistic issues, patient-staff communication, and also perceptions of the patients toward the outbreak. Materials and Methods: This study was conducted from April to September 2020. A questionnaire was created for which the patients were asked to provide answers. Parameters assessed included general information such as mode of transport used, frame of mind during treatment, awareness about pandemic, satisfaction toward care provided by health-care staff, and also documenting the suggestions to improve the quality of care. Results: During this period, we interviewed 108 patients: 56 males (51.9%) and 52 females (48.1%). 90.7% of the participants were satisfied with the condition and safety measures employed in waiting area and billing section. Majority (88.9%) were found to be aware about COVID-19. 74.1% of the participants were very satisfied with the services provided to them in the department of radiation oncology. Conclusion: The survey was useful in measuring the patient satisfaction, in understanding their fears and anxieties, and also in determining their awareness about the pandemic. The survey was also useful to get the patients' opinion and ideas for improvement in the health-care services.


Subject(s)
Neoplasms/radiotherapy , Patient Satisfaction/statistics & numerical data , Professional-Patient Relations , Tertiary Care Centers/statistics & numerical data , Adult , Aged , Anxiety/psychology , COVID-19/epidemiology , Communication , Fear/psychology , Female , Humans , India/epidemiology , Male , Middle Aged , Patient Safety , Quality of Health Care , SARS-CoV-2 , Surveys and Questionnaires
3.
J Cyst Fibros ; 20 Suppl 3: 3-8, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587345

ABSTRACT

BACKGROUND: Novel therapies have dramatically changed cystic fibrosis (CF) and innovative care delivery systems are needed to meet future patient needs. Telehealth has been shown to be an efficient and desirable form of care delivery. The COVID-19 pandemic caused a rapid shift to telehealth, and this presented a unique opportunity to study facilitators, barriers, and satisfaction with this mode of care delivery. We aim to report survey methods, demographics and telehealth use among CF care programs, patients, and families during the pandemic. METHODS: CF programs completed two surveys between July 29 and September 18, 2020, and between April 19 and May 19, 2021. Patients and families completed a similar survey between August 31 and October 30, 2020. The surveys addressed topics assessing the pandemic's financial impact, telehealth modes and experiences, licensure and reimbursement issues, health screening, and remote monitoring. Quantitative data were analyzed with descriptive statistics and were compared to the CF Foundation Patient Registry. RESULTS: Most programs (278 at timepoint one and 274 at timepoint two) provided telehealth during the pandemic. The percent of visits containing either telephone or video components changed from 45% to 25% over the time periods. Additionally, 424 patients and families from various ages and backgrounds responded to the survey and 81% reported having a telehealth visit. CONCLUSIONS: The pandemic accelerated telehealth adoption and these datasets are a valuable source for exploring telehealth barriers and facilitators, the quality-of-care experience, financial and workforce implications, the impact on underrepresented populations, and implications for coverage and reimbursement.


Subject(s)
COVID-19 , Cystic Fibrosis , Health Services Accessibility , Telemedicine , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control/methods , Communication Barriers , Continuity of Patient Care , Costs and Cost Analysis , Cystic Fibrosis/epidemiology , Cystic Fibrosis/psychology , Cystic Fibrosis/therapy , Female , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Humans , Male , Organizational Innovation , Patient Satisfaction/statistics & numerical data , Quality of Health Care , SARS-CoV-2 , Telemedicine/organization & administration , Telemedicine/standards , United States/epidemiology
4.
J Cyst Fibros ; 20 Suppl 3: 9-13, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587343

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) care programs in the United States rapidly adopted telehealth during the COVID-19 pandemic. Understanding factors that promote or impede telehealth will inform planning for future telehealth-enabled care models. METHODS: Adult, pediatric, and affiliate CF care programs in the United States (n = 287) were surveyed twice eight months apart in 2020-2021 about telehealth use. Programs were asked to describe barriers to and promoters of telehealth. RESULTS: Ninety-seven percent of programs provided telehealth services. In the first CF Care Program State of Care Survey (SoC1), programs estimated that 57% of patients exclusively received in-person care, 36% of patients received telehealth by phone/computer with video, and 8% of patients received telephone-only care. In the second CF Care Program State of Care Survey (SoC2), programs estimated that 80% of visits were in-person and 15% were via audio and video telehealth. Pediatric programs (21%) were less likely than adult (37%) or affiliate (41%) programs to recommend telehealth (p = 0.007). All programs ranked lack of internet access as the highest barrier to patient engagement with telehealth. Promoters of telehealth were increased accessibility and avoidance of infection transmission. Top ranked changes to improve telehealth were expanded provision of remote monitoring devices and technology access. Similar proportions of program types anticipated institutional telehealth expansion. CONCLUSION: During the COVID-19 pandemic, CF programs in the United States identified factors to improve future care delivery via telehealth. Targeting specific barriers and promoters will improve the use and quality of telehealth throughout the care center network.


Subject(s)
COVID-19 , Communication Barriers , Cystic Fibrosis , Disease Transmission, Infectious/prevention & control , Health Services Accessibility , Patient Participation , Telemedicine , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Cystic Fibrosis/epidemiology , Cystic Fibrosis/psychology , Cystic Fibrosis/therapy , Female , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Humans , Internet Access , Male , Needs Assessment , Patient Participation/methods , Patient Participation/psychology , Patient Satisfaction/statistics & numerical data , Quality Improvement , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/standards , United States/epidemiology
6.
J Healthc Manag ; 66(4): 258-270, 2021.
Article in English | MEDLINE | ID: covidwho-1475897

ABSTRACT

EXECUTIVE SUMMARY: Home hospital care (HHC) is a new and exciting concept that holds the promise of achieving all three components of the Triple Aim and reducing health disparities. As an innovative care delivery model, HHC substitutes traditional inpatient hospital care with hospital care at home for older patients with certain conditions. Studies have shown evidence of reduced cost of care, improved patient satisfaction, and enhanced quality and safety of care for patients treated through this model. The steady growth in Medicare Advantage enrollment and the expansion in 2020 of the Centers for Medicare & Medicaid Services (CMS) Hospitals Without Walls program to include acute hospital care at home creates an opportunity for hospitals to implement such programs and be financially rewarded for reducing costs. Capacity constraints exacerbated by the COVID-19 pandemic suggest that now is the ideal time for healthcare leaders to test and advance the concept of HHC in their communities.


Subject(s)
COVID-19 , Critical Care Nursing/economics , Critical Care Nursing/standards , Healthcare Disparities/standards , Home Care Services/economics , Home Care Services/standards , Quality of Health Care/standards , Adult , Aged , Aged, 80 and over , Female , Healthcare Disparities/economics , Healthcare Disparities/statistics & numerical data , Home Care Services/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Patient Satisfaction/statistics & numerical data , Practice Guidelines as Topic , Quality of Health Care/economics , Quality of Health Care/statistics & numerical data , SARS-CoV-2 , United States
7.
Med Care ; 59(8): 694-698, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1393508

ABSTRACT

BACKGROUND: Concerns exist regarding exacerbation of existing disparities in health care access with the rapid implementation of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. However, data on pre-existing disparities in telemedicine utilization is currently lacking. OBJECTIVE: We aimed to study: (1) the prevalence of outpatient telemedicine visits before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income; and (2) associated diagnosis categories. RESEARCH DESIGN: This was a retrospective cohort study. SUBJECT: Commercial claims data from the Truven MarketScan database (2014-2018) representing n=846,461,609 outpatient visits. MEASURES: We studied characteristics and utilization of outpatient telemedicine services before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income. Disparities were assessed in unadjusted and adjusted (regression) analyses. RESULTS: With overall telemedicine uptake of 0.12% (n=1,018,092/846,461,609 outpatient visits) we found that pre-COVID-19 disparities in telemedicine use became more pronounced over time with lower use in patients who were older, had more comorbidities, were in rural areas, and had lower median household incomes (all trends and effect estimates P<0.001). CONCLUSION: These results contextualize pre-existing disparities in telemedicine use and are crucial in the monitoring of potential disparities in telemedicine access and subsequent outcomes after the rapid expansion of telemedicine during the COVID-19 pandemic.


Subject(s)
Ambulatory Care/trends , COVID-19/therapy , Health Services Accessibility/trends , Healthcare Disparities/statistics & numerical data , Telemedicine/trends , Adult , COVID-19/epidemiology , Humans , Infection Control/trends , Male , Middle Aged , Patient Satisfaction/statistics & numerical data , Quality Improvement , Retrospective Studies
8.
Am J Addict ; 30(5): 445-452, 2021 09.
Article in English | MEDLINE | ID: covidwho-1360443

ABSTRACT

BACKGROUND AND OBJECTIVES: The rapid scale-up of telehealth services for substance use disorders (SUDs) during the COVID-19 pandemic presented a unique opportunity to investigate patient experiences with telehealth. This study examined patient perceptions of telehealth in an outpatient SUD treatment program offering individual therapy, group therapy, and medication management. METHODS: Two hundred and seventy adults receiving SUD outpatient treatment were eligible to complete a 23-item online survey distributed by clinicians; 58 patients completed/partially completed the survey. Data were summarized with descriptive statistics. RESULTS: Participants were predominately male, White, and well-educated. The majority (86.2%) were "very satisfied" or "satisfied" with the quality of telehealth care. "Very satisfied" ratings were highest for individual therapy (90%), followed by medication management (75%) and group therapy (58%). Top reasons for liking telehealth included the ability to do it from home (90%) and not needing to spend time commuting (83%). Top reasons for disliking telehealth were not connecting as well with other members in group therapy (28%) and the ability for telehealth to be interrupted at home or work (26%). DISCUSSION AND CONCLUSIONS: Telehealth visits were a satisfactory treatment modality for most respondents receiving outpatient SUD care, especially those engaging in individual therapy. Challenges remain for telehealth group therapy. SCIENTIFIC SIGNIFICANCE: This is the first study examining patients' perceptions of telehealth for outpatient SUD treatment during the COVID-19 pandemic by treatment service type. Importantly, while many participants found telehealth more accessible than in-person treatment, there was variability with respect to the preferred mode of treatment delivery.


Subject(s)
Ambulatory Care , COVID-19 , Outpatients , Pandemics , Patient Satisfaction , Substance-Related Disorders , Telemedicine , Adult , Ambulatory Care/methods , COVID-19/epidemiology , Female , Health Care Surveys , Humans , Male , Outpatients/psychology , Outpatients/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Psychotherapy, Group , Substance-Related Disorders/therapy
9.
World Neurosurg ; 154: e781-e789, 2021 10.
Article in English | MEDLINE | ID: covidwho-1347859

ABSTRACT

OBJECTIVE: To assess the feasibility, patient/provider satisfaction, and perceived value of telehealth spine consultation after rapid conversion from traditional in-office visits during the COVID-19 pandemic. METHODS: Data were obtained for patients undergoing telehealth visits with spine surgeons in the first 3 weeks after government restriction of elective surgical care at 4 sites (March 23, 2020, to April 17, 2020). Demographic factors, technique-specific elements of the telehealth experience, provider confidence in diagnostic and therapeutic assessment, patient/surgeon satisfaction, and perceived value were collected. RESULTS: A total of 128 unique visits were analyzed. New (74 [58%]), preoperative (26 [20%]), and postoperative (28 [22%]) patients were assessed. A total of 116 (91%) visits had successful connection on the first attempt. Surgeons felt very confident 101 times (79%) when assessing diagnosis and 107 times (84%) when assessing treatment plan. The mean and median patient satisfaction was 89% and 94%, respectively. Patient satisfaction was significantly higher for video over audio-only visits (P < 0.05). Patient satisfaction was not significantly different with patient age, location of chief complaint (cervical or thoracolumbar), or visit type (new, preoperative, or postoperative). Providers reported that 76% of the time they would choose to perform the visit again in telehealth format. Sixty percent of patients valued the visit cost as the same or slightly less than an in-office consultation. CONCLUSIONS: This is the first study to demonstrate the feasibility and high patient/provider satisfaction of virtual spine surgical consultation, and appropriate reimbursement and balanced regulation for spine telehealth care is essential to continue this existing work.


Subject(s)
COVID-19 , Feasibility Studies , Neurosurgeons , Pandemics , Physical Examination/methods , Spinal Diseases/diagnosis , Telemedicine/methods , Adult , Age Factors , Aged , Aged, 80 and over , Attitude of Health Personnel , Female , Health Personnel , Humans , Male , Middle Aged , Patient Satisfaction/statistics & numerical data , Postoperative Care , Preoperative Care
10.
J Laryngol Otol ; 135(9): 815-819, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1333849

ABSTRACT

OBJECTIVE: To review patient satisfaction with the change in practice towards telephone consultations during and after the coronavirus disease 2019 pandemic for head and neck cancer follow up. METHOD: A retrospective analysis was conducted of head and neck cancer telephone appointments during a six-month period in a tertiary referral centre. RESULTS: Patients found the telephone consultations beneficial (98 per cent), with 30 per cent stating they were relieved to not have to attend hospital. Patients who travelled further, those with lower stage disease and patients with a greater interval from initial treatment were most satisfied with the telephone consultations. Sixty-eight per cent of patients stated they would be happy to have telephone consultations as part of their regular follow up after the pandemic. CONCLUSION: Patients found the telephone consultations beneficial and 30 per cent considered them preferable to face-to-face appointments. This study demonstrates that telephone consultations can be used as an adjunct to face-to-face appointments in an effort to reduce hospital attendances whilst maintaining close follow up.


Subject(s)
Aftercare , Head and Neck Neoplasms/therapy , Patient Satisfaction , Referral and Consultation , Adult , Aftercare/methods , Aftercare/psychology , Aftercare/standards , Aged , Aged, 80 and over , Humans , Middle Aged , Patient Satisfaction/statistics & numerical data , Retrospective Studies , Telephone , Tertiary Care Centers
11.
Urology ; 156: 110-116, 2021 10.
Article in English | MEDLINE | ID: covidwho-1331280

ABSTRACT

OBJECTIVE: To examine differences between telephone and video-televisits and identify whether visit modality is associated with satisfaction in an urban, academic general urology practice. METHODS: A cross sectional analysis of patients who completed a televisit at our urology practice (summer 2020) was performed. A Likert-based satisfaction telephone survey was offered to patients within 7 days of their televisit. Patient demographics, televisit modality (telephone vs video), and outcomes of the visit (eg follow-up visit scheduled, orders placed) were retrospectively abstracted from each chart and compared between the telephone and video cohorts. Multivariate regression analysis was used to evaluate variables associated with satisfaction while controlling for potential confounders. RESULTS: A total of 269 patients were analyzed. 73% (196/269) completed a telephone televisit. Compared to the video cohort, the telephone cohort was slightly older (mean 58.8 years vs. 54.2 years, P = .03). There were no significant differences in the frequency of orders placed for medication changes, labs, imaging, or for in-person follow-up visits within 30 days between cohorts. Survey results showed overall 84.7% patients were satisfied, and there was no significant difference between the telephone and video cohorts. Visit type was not associated with satisfaction on multivariable analyses, while use of an interpreter [OR:8.13 (1.00-65.94); P = .05], labs ordered [OR:2.74 (1.12-6.70); P = .03] and female patient gender [OR:2.28 (1.03-5.03); P = .04] were significantly associated with satisfaction. CONCLUSION: Overall, most patients were satisfied with their televisit. Additionally, telephone- and video-televisits were similar regarding patient opinions, patient characteristics, and visit outcome. Efforts to increase access and coverage of telehealth, particularly telephone-televisits, should continue past the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Patient Satisfaction/statistics & numerical data , Telemedicine/methods , Telephone , Urology/statistics & numerical data , Videoconferencing , Adolescent , Adult , African Americans/statistics & numerical data , Aged , Asian Americans/statistics & numerical data , Clinical Laboratory Techniques , Communication Barriers , Cross-Sectional Studies , Female , Humans , Institutional Practice/statistics & numerical data , Language , Male , Middle Aged , Patient Satisfaction/ethnology , Retrospective Studies , SARS-CoV-2 , Sex Factors , Smoking , Surveys and Questionnaires , Transportation , Urban Population/statistics & numerical data , Young Adult
12.
Future Oncol ; 17(27): 3615-3625, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1317191

ABSTRACT

Aim: Patient and worker satisfaction at an oncologic hub during the COVID-19 pandemic has never been reported. We addressed this topic. Methods: We conducted a survey to test the views of patients (n = 64) and healthcare professionals (n = 52) involved with our operative protocol. Results: A moderate/severe grade of concern due to the COVID-19 emergency was recorded in 63% of patients versus 75% of hospital staff. High/very high versus low satisfaction grade about preventive strategies to reduce the risk of SARS-CoV-2 contagion was identified in the patients compared with the hospital staff group. Conclusion: Surgical treatment at a hub center of uro-oncologic patients coming from spoke centers is well accepted and should, therefore, be recommended. Preventive strategies to reduce the risk of SARS-CoV-2 contagion in hospital staff members should be implemented.


Lay abstract We provide robust evidence that an oncologic hub center during COVID-19 pandemic represents a credible solution for management of non-deferrable uro-oncologic patients. Specifically, surgical treatment at a hub center of patients coming from spoke centers is well accepted by both patients and hospital staff members. Moreover, collaboration between healthcare workers from spoke and hub centers generates minimal levels of anxiety, while potentially being associated with clinical, surgical and scientific improvement. This said, a more specific focus on recommended strategies to reduce the risk of SARS-CoV-2 contagion at oncologic hub hospitals is warranted.


Subject(s)
Attitude of Health Personnel , COVID-19 , Patient Satisfaction , Urologic Neoplasms/surgery , COVID-19/prevention & control , COVID-19/psychology , Humans , Italy , Patient Satisfaction/statistics & numerical data , Personal Protective Equipment , Retrospective Studies , Surveys and Questionnaires , Urologic Neoplasms/psychology
13.
Ann R Coll Surg Engl ; 103(7): 520-523, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288675

ABSTRACT

INTRODUCTION: In light of the COVID-19 recommendations from the Association of Coloproctology of Great Britain and Ireland, we aimed to study patient and clinician satisfaction with a newly established telephone (TP) colorectal clinic service in lieu of traditional face-to-face (FTF) appointments. Comparative outcomes included patient versus clinician satisfaction; patient versus clinician desire to continue TP clinics postpandemic; and views of Specialty Trainee 3+ (ST3+)/Specialty Associate Specialist (SAS) doctors versus consultants on TP compared with FTF appointments. METHODS: We conducted a prospective service evaluation of patient and clinician satisfaction with colorectal surgery TP clinics between 1 June 2020 and 30 June 2020 in a British District General Hospital. RESULTS: Patients had higher satisfaction than clinicians with TP clinics: 91.5% versus 66.6% reported above-average experience [odds ratio (OR) = 5.35, 95% confidence interval (CI) 1.53 to 18.75, p = 0.01]. Clinicians had lower demand to continue TP clinics post-COVID-19 versus patients, with a trend towards significance (60% versus 82.9%, OR = 0.31, 95% CI 0.10 to 0.97, p = 0.08). ST3+/SAS doctors were more likely than consultants to find TP clinics inferior to FTF consultation for patient assessment (48.3% versus 23.7%, OR = 3.00, 95% CI 1.17 to 7.71, p = 0.03). CONCLUSIONS: While clinicians may be concerned that patient assessment suffers, patient satisfaction with TP clinics is high. There should be a place for TP clinics post-COVID-19 but there must be a robust process for patient selection as well as adequate training for current and future generations of clinicians.


Subject(s)
COVID-19/prevention & control , Colorectal Neoplasms/diagnosis , Medical Oncology/methods , Remote Consultation/methods , Telephone , Aftercare/methods , Aftercare/standards , Aftercare/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Colorectal Neoplasms/therapy , Humans , Infection Control/standards , Job Satisfaction , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Prospective Studies , Remote Consultation/standards , Remote Consultation/statistics & numerical data , Surgeons/psychology , Surgeons/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , United Kingdom/epidemiology
15.
Headache ; 61(5): 734-739, 2021 05.
Article in English | MEDLINE | ID: covidwho-1238428

ABSTRACT

OBJECTIVE: We sought to investigate the patient experience of telemedicine for headache care during the coronavirus disease 2019 (COVID-19) pandemic. BACKGROUND: The use of telemedicine has rapidly expanded and evolved since the beginning of the COVID-19 pandemic. Telemedicine eliminates the physical and geographic barriers to health care, preserves personal protective equipment, and prevents the spread of COVID-19 by allowing encounters to happen in a socially distanced way. However, few studies have assessed the patient perspective of telemedicine for headache care. METHODS: The American Migraine Foundation (AMF) designed a standardized electronic questionnaire to assess the patient experience of telemedicine for headache care between March and September 2020 to help inform future quality improvement as part of its patient advocacy initiative. The date parameters were identified as the emergence of severe acute respiratory syndrome coronavirus 2 disease and the declaration of a national emergency in the United States. The questionnaire was distributed electronically to more than 100,000 members of the AMF community through social media platforms and the AMF email database. RESULTS: A total of 1172 patients responded to our electronic questionnaire, with 1098 complete responses. The majority, 1081/1153 (93.8%) patients, had a previous headache diagnosis prior to the telemedicine encounter. A total of 648/1127 (57.5%) patients reported that they had used telemedicine for headache care during the study period. Among those who participated in telehealth visits, 553/647 (85.5%) patients used it for follow-up visits; 94/647 (14.5%) patients used it for new patient visits. During the telemedicine encounters, 282/645 (43.7%) patients were evaluated by headache specialists, 222/645 (34.4%) patients by general neurologists, 198/645 (30.7%) patients by primary care providers, 73/645 (11.3%) patients by headache nurse practitioners, and 21/645 (3.2%) patients by headache nurses. Only 47/633 (7.4%) patients received a new headache diagnosis from telemedicine evaluation, whereas the other 586/633 (92.6%) patients did not have a change in their diagnoses. During these visits, a new treatment was prescribed for 358/636 (52.3%) patients, whereas 278/636 (43.7%) patients did not have changes made to their treatment plan. The number (%) of patients who rated the telemedicine headache care experience as "very good," "good," "fair," "poor," and "other" were 396/638 (62.1%), 132/638 (20.7%), 67/638 (10.5%), 23/638 (3.6%), and 20/638 (3.1%), respectively. Detailed reasons for "other" are listed in the manuscript. Most patients, 573/638 (89.8%), indicated that they would prefer to continue to use telemedicine for their headache care, 45/638 (7.1%) patients would not, and 20/638 (3.1%) patients were unsure. CONCLUSIONS: Our study evaluating the patient perspective demonstrated that telemedicine facilitated headache care for many patients during the COVID-19 pandemic, resulting in high patient satisfaction rates, and a desire to continue to use telemedicine for future headache care among those who completed the online survey.


Subject(s)
Aftercare/statistics & numerical data , COVID-19 , Headache Disorders/therapy , Patient Satisfaction/statistics & numerical data , Process Assessment, Health Care/statistics & numerical data , Telemedicine/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Female , Foundations , Headache Disorders/diagnosis , Health Care Surveys , Humans , Male , Middle Aged , Young Adult
16.
PLoS One ; 16(5): e0251382, 2021.
Article in English | MEDLINE | ID: covidwho-1218947

ABSTRACT

BACKGROUND: The presence of COVID-19 has led to the disruption of health systems globally, including essential reproductive, maternal, newborn and child health (RMNCH) services. This study aimed to assess the challenges faced by women who used RMNCH services in Nigeria's epicentre, their satisfaction with care received during the COVID-19 pandemic and the factors associated with their satisfaction. METHODS: This cross-sectional survey was conducted in Lagos, southwest Nigeria among 1,241 women of reproductive age who had just received RMNCH services at one of twenty-two health facilities across the primary, secondary and tertiary tiers of health care. The respondents were selected via multi-stage sampling and face to face exit interviews were conducted by trained interviewers. Client satisfaction was assessed across four sub-scales: health care delivery, health facility, interpersonal aspects of care and access to services. Bivariate and multivariate analyses were used to assess the relationship between personal characteristics and client satisfaction. RESULTS: About 43.51% of respondents had at least one challenge in accessing RMNCH services since the COVID-19 outbreak. Close to a third (31.91%) could not access service because they could not leave their houses during the lockdown and 18.13% could not access service because there was no transportation. The mean clients' satisfaction score among the respondents was 43.25 (SD: 6.28) out of a possible score of 57. Satisfaction scores for the interpersonal aspects of care were statistically significantly lower in the PHCs and general hospitals compared to teaching hospitals. Being over 30 years of age was significantly associated with an increased clients' satisfaction score (ß = 1.80, 95%CI: 1.10-2.50). CONCLUSION: The COVID-19 lockdown posed challenges to accessing RMNCH services for a significant proportion of women surveyed. Although overall satisfaction with care was fairly high, there is a need to provide tailored COVID-19 sensitive inter-personal care to clients at all levels of care.


Subject(s)
Child Health Services , Maternal Health Services , Patient Satisfaction , Reproductive Health Services , Adolescent , Adult , COVID-19/epidemiology , COVID-19/pathology , COVID-19/virology , Cross-Sectional Studies , Female , Health Facilities/statistics & numerical data , Humans , Infant, Newborn , Linear Models , Male , Middle Aged , Nigeria/epidemiology , Pandemics , Patient Satisfaction/statistics & numerical data , Pregnancy , SARS-CoV-2/isolation & purification , Young Adult
17.
Contraception ; 104(3): 254-261, 2021 09.
Article in English | MEDLINE | ID: covidwho-1188440

ABSTRACT

OBJECTIVE: During theCOVID-19 pandemic, many clinicians increased provision of telemedicine services. This study describes patient experiences with telemedicine for contraceptive counseling during the COVID-19 pandemic in New York City. STUDY DESIGN: This is a mixed-methods study which includes a web-based or phone survey and in-depth phone interviews with patients who had telemedicine visits for contraception. RESULTS: A total of 169 patients had eligible telemedicine visits between April 1 and June 30, 2020. Of these, 86 (51%) responded to the survey, and 23 (14%) participated in the interviews. We found that 86% of survey respondents were very satisfied with the telemedicine visit, and 63% said it completely met their needs. A majority (73%) strongly agreed that these visits should be maintained after the COVID-19 pandemic, and half (51%) would be very likely to choose them over in-person visits. In-depth interviews highlighted the convenience of telemedicine, especially for those with work or parenting responsibilities. Although some patients had in-person visits after telehealth, many appreciated the counseling they received remotely, and found the subsequent in-person visits more efficient. Patients identified visits that do not require physical exams as ideal visits for telehealth, and some hoped that all or most of their future visits would be telehealth visits. Many patients (43%) expressed a preference for phone over video visits. CONCLUSIONS: Patients reported an overall positive experience with telemedicine visits for contraceptive counseling during the COVID-19 pandemic. They appreciated the convenience of telemedicine visits and valued the virtual counseling experience. IMPLICATIONS: Health care providers who initiated or expanded telemedicine services for contraceptive counseling during the COVID-19 pandemic should consider continuing to offer them after the pandemic. At the policy level, these findings favor expanding access to telemedicine and providing reimbursement for virtual visits, including telephone visits.


Subject(s)
COVID-19/prevention & control , Contraception , Directive Counseling/methods , Family Planning Services/methods , Patient Satisfaction/statistics & numerical data , Telemedicine/methods , Adolescent , Adult , COVID-19/epidemiology , Directive Counseling/trends , Family Planning Services/trends , Female , Humans , Interviews as Topic , Male , Middle Aged , New York City/epidemiology , Pandemics , Qualitative Research , Telemedicine/trends , Young Adult
18.
Phys Ther ; 101(7)2021 07 01.
Article in English | MEDLINE | ID: covidwho-1180611

ABSTRACT

OBJECTIVE: COVID-19 has widely affected delivery of health care. In response, telerehabilitation (TR) has emerged as alternative care model. Aims were: (1) to describe baseline patient characteristics and available unadjusted outcomes for episodes of care administered during COVID-19 using TR versus traditional in-person care, and (2) to describe TR frequency levels by condition and telecommunication modes. METHODS: A descriptive retrospective observational design was used to report patient variables and outcomes including physical function, number of visits, and patient satisfaction, by TR frequency (few, most, or all visits) and telecommunication modes. Standardized differences were used to compare baseline characteristics between episodes with and without TR. RESULTS: Sample consisted of 222,680 patients (59% female; mean [SD] age = 55 [18] years). Overall TR rate was 6% decreasing from 10% to 5% between second and third quarters of 2020. Outcome measures were available for 90% to 100% of episodes. Thirty-seven percent of clinicians administered care via TR. Patients treated using TR compared with in-person care were more likely to be younger and live in large metropolitan areas. From those with TR, 55%, 20%, and 25% had TR during few, most, or all visits, respectively. TR care was administered equally across orthopedic body parts, with lower use for nonorthopedic conditions such as stroke, edema, and vestibular dysfunction. TR was primarily administered using synchronous (video or audio) modes. The rate of patients reported being very satisfied with their treatment results was 3% higher for no TR compared with TR. CONCLUSIONS: These results provide new knowledge about to whom and how TR is being administered during the pandemic in outpatient rehabilitation practices throughout the United States. The database assessed was found to be suitable for conducting studies on associations between TR and diverse outcome measures, controlling for a comprehensive set of patient characteristics, to advance best TR care models, and promote high-quality care. IMPACT: This study provided detailed and robust descriptive information using an existing national patient database containing patient health and demographic characteristics, outcome measures, and telerehabilitation (TR) administration data. Findings support the feasibility to conduct future studies on associations between TR care and patient outcomes, adjusting for a wide range of patient characteristics and clinical setting factors that may be associated with the probability of receiving TR. The finding of limited and decreasing use of TR over the study period calls for studies aimed to better understand facilitators and inhibitors of TR use by rehabilitation therapists during everyday practice to promote its use when clinically appropriate.


Subject(s)
COVID-19/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Quality of Life/psychology , Telerehabilitation/statistics & numerical data , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Outpatients/statistics & numerical data , Retrospective Studies , Treatment Outcome
19.
Bull Cancer ; 108(5): 481-489, 2021 May.
Article in French | MEDLINE | ID: covidwho-1179281

ABSTRACT

Confinement within the framework of Covid 19 required organizations in cancer centers, in particular with postponing certain treatments. We interviewed 6080 patients who had a scheduled appointment during this period. 2478 patients gave their opinion regarding access and organization of care, teleconsultation, their concerns and their reasons for satisfaction. While 83 % of them say they are satisfied with the organization of care, 25 % of respondents say they have given up care that they consider essential in 1/3 of cases. The concern related to the follow-up of the cancerous disease takes precedence over that of being infected with the Sars-cov-2 virus, unlike the general population, and relationships with their loved ones are spontaneously cited as a reason for satisfaction. This method captures the experience of patients, despite certain limitations. Such an approach could be used to set up a specific system during normal periods.


Subject(s)
Activities of Daily Living , COVID-19/epidemiology , Cancer Care Facilities , Neoplasms/therapy , Patient Satisfaction/statistics & numerical data , Quarantine , Adult , Aged , Appointments and Schedules , COVID-19/psychology , Chi-Square Distribution , Continuity of Patient Care/standards , Family Relations/psychology , Female , France/epidemiology , Health Services Accessibility , Humans , Male , Middle Aged , Neoplasms/psychology , Remote Consultation
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