A comparison study of the turnaround time for telepsychiatry versus face-to-face consultations in general hospital nonpsychiatric emergency rooms.

BACKGROUND: Psychiatric consultation services, particularly for emergencies, are limited in many parts of the United States. Telepsychiatry services are helping to bridge the gap, and are gaining acceptance and popularity. There is paucity of publications regarding comparison of turnaround time for consultations between video conferencing and traditional face-to-face psychiatric consultations in general hospital nonpsychiatric emergency departments (EDs). Our study aimed to address turnaround time and patient satisfaction. METHODS: Data regarding the turnaround time for emergency psychiatric consultations using telepsychiatry in general hospital EDs was collected retrospectively and compared with the time for face-to-face traditional consultations. A patient satisfaction survey was also conducted after the telepsychiatry consultation. Statistical analysis of the data was done after the study was completed. RESULTS: The telepsychiatry group included 206 participants and the control group had 186 participants. There was an 84% reduction in the turnaround time for telepsychiatry consults (95% confidence interval, 81% to 86%). A patient satisfaction survey showed 97% satisfaction with telepsychiatry services. Gender and age did not modify the effect of telepsychiatry on time to consult (P > .10). CONCLUSIONS: The reduction in the turnaround time and improved patient satisfaction indicate that telepsychiatry services can improve the quality of care for patients in need of emergency services.

Does Objective Quality of Physicians Correlate with Patient Satisfaction Measured by Hospital Compare Metrics in New York State?

BACKGROUND: It is unclear whether publicly reported benchmarks correlate with quality of physicians and institutions. We investigated the association of patient satisfaction measures from a public reporting platform with performance of neurosurgeons in New York State. METHODS: This cohort study comprised patients undergoing neurosurgical operations from 2009 to 2013 who were registered in the Statewide Planning and Research Cooperative System database. The cohort was merged with publicly available data from the Centers for Medicare and Medicaid Services Hospital Compare website. Propensity-adjusted regression analysis was used to investigate the association of patient satisfaction metrics with neurosurgeon quality, as measured by the neurosurgeon's individual rate of mortality and average length of stay. RESULTS: During the study period, 166,365 patients underwent neurosurgical procedures. Using propensity-adjusted multivariable regression analysis, we demonstrated that undergoing neurosurgical operations in hospitals with a greater percentage of patient-assigned "high" scores was associated with higher chance of being treated by a physician with superior performance in terms of mortality (odds ratio 1.90, 95% confidence interval 1.86-1.95), and a higher chance of being treated by a physician with superior performance in terms of length of stay (odds ratio 1.24, 95% confidence interval 1.21-1.27). Similar associations were identified for hospitals with a higher percentage of patients who claimed they would recommend these institutions to others. CONCLUSIONS: Merging a comprehensive all-payer cohort of neurosurgery patients in New York State with data from the Hospital Compare website, we observed an association of superior hospital-level patient satisfaction measures with objective performance of individual neurosurgeons in the corresponding hospitals.