骨科虚拟诊所的访问是否与面对面的访问相比,证明了成本和时间的效率?
Nicholas Livingston1, Alex Lindahl2, Jack McConnell1
1Wayne State University School of Medicine, Detroit, MI, USA.
Clinical orthopaedics and related research
|August 25, 2023
概括
在骨科手术中,虚拟访问的成本效益并不比面对面的访问更高. 基于时间驱动的基于活动的成本计算 (TDABC) 显示,虚拟咨询的成本更高,尽管人员的时间减少了.
科学领域:
- 整形外科手术 整形外科手术
- 卫生经济学 卫生经济学
- 远程医疗远程医疗
背景情况:
- 远程医疗在骨科中越来越多地使用,因为人们认为它具有成本效益.
- 没有研究比较了虚拟与实体骨科访问,使用基于时间驱动的基于活动的成本计算 (TDABC).
- 对于基于价值的医疗保健来说,TDABC提供精确的成本测量至关重要.
研究的目的:
- 使用TDABC比较虚拟与实体骨科诊所的成本.
- 评估TDABC成本估计是否不同于成本与费用 (RCC) 的比率.
- 评估虚拟和实体环境之间的医疗人员和外科医生时间的变化.
主要方法:
- 展望性,观察性研究90个实体和90个虚拟回访跨越关节,手和体育子专业.
- 通过测量员工时间,利用TDABC进行虚拟和面对面访问的不同流程地图.
- 来自医院会计部门的费用与费用 (RCC) 数据的获取比率.
主要成果:
- TDABC显示,虚拟访问的成本为140美元 (IQR美元113-205美元),而面对面访问的成本为127美元 (IQR美元111-163美元) (p=0.16).
- 在六个服务级别中的五个,RCC高估了TDABC成本.
- 虚拟访问使用的总人员时间减少了 (13分钟与17分钟相比),但外科医生花费的时间更多 (8分钟与6分钟相比).
结论:
- 整形外科虚拟诊所与实体诊所相比,没有节省成本.
- 外科医生的时间承诺和临床场所参与抵消了潜在的节省.
- 成本不是主要优势;患者的偏好和满意度应该指导虚拟访问的采用.
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