澳大利亚全科医生对远程医疗咨询的偏好:试点调查和离散选择实验。

Keshia R De Guzman, Anthony C Smith, Centaine L Snoswell
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引用次数: 0

摘要

目的:确定并量化澳大利亚全科医生(GP)对临床咨询(包括远程医疗咨询)服务属性的偏好:背景:自 2019 年冠状病毒病(COVID-19)大流行以来,全科医生越来越多地使用远程医疗为患者提供护理服务。全科医生对远程医疗服务模式的偏好将在大流行后远程医疗服务的吸收和可持续性方面发挥重要作用:方法:采用在线调查的方式向全科医生询问有关远程保健的一般问题,并让他们完成离散选择实验(DCE)。离散选择实验了解全科医生对远程保健(电话和视频会议)咨询的各种服务属性的偏好。离散选择实验调查了五种服务属性,包括会诊模式、会诊目的、会诊时长、护理质量和融洽关系以及患者共同付费。向参与者展示了八个选择集,每个选择集包含三个选项。研究采用了描述性统计方法,并使用混合对数模型对 DCE 数据进行估计和分析:共有 60 名全科医生完成了调查。以往的远程医疗经验直接影响了人们对各种临床表现的远程医疗会诊的偏好,尽管人们普遍偏好面对面模式(在所有情景中约占 70%)。DCE 的结果缺乏统计意义,表明全科医生对某些服务属性的偏好存在明显差异。然而,研究发现,全科医生更倾向于提供具有优质护理和融洽关系的咨询(P < 002)。全科医生也更愿意为病人提供护理,而不是因为会诊模式、会诊时间或目的而拒绝会诊(P < 0.0001)。根据研究结果,全科医生重视在临床问诊过程中提供高质量护理和建立融洽关系的能力。这凸显了在未来的政策改革中承认基于价值的护理的重要性,以确保全科医生远程医疗服务在澳大利亚的持续应用和可持续性。
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General practitioner preferences for telehealth consultations in Australia: a pilot survey and discrete choice experiment.

Aim: To identify and quantify general practitioner (GP) preferences related to service attributes of clinical consultations, including telehealth consultations, in Australia.

Background: GPs have been increasingly using telehealth to deliver patient care since the onset of the 2019 coronavirus disease (COVID-19) pandemic. GP preferences for telehealth service models will play an important role in the uptake and sustainability of telehealth services post-pandemic.

Methods: An online survey was used to ask GPs general telehealth questions and have them complete a discrete choice experiment (DCE). The DCE elicited GP preferences for various service attributes of telehealth (telephone and videoconference) consultations. The DCE investigated five service attributes, including consultation mode, consultation purpose, consultation length, quality of care and rapport, and patient co-payment. Participants were presented with eight choice sets, each containing three options to choose from. Descriptive statistics was used, and mixed logit models were used to estimate and analyse the DCE data.

Findings: A total of 60 GPs fully completed the survey. Previous telehealth experiences impacted direct preferences towards telehealth consultations across clinical presentations, although in-person modes were generally favoured (in approximately 70% of all scenarios). The DCE results lacked statistical significance which demonstrated undiscernible differences between GP preferences for some service attributes. However, it was found that GPs prefer to provide a consultation with good quality care and rapport (P < 002). GPs would also prefer to provide care to their patients rather than decline a consultation due to consultation mode, length or purpose (P < 0.0001). Based on the findings, GPs value the ability to provide high-quality care and develop rapport during a clinical consultation. This highlights the importance of recognising value-based care for future policy reforms, to ensure continued adoption and sustainability of GP telehealth services in Australia.

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