Pre-Operative Assessment Through Consultation by Phone or Video: Effect on Perceived Quality of Care

Abstract

Background Telemedicine has been used for several decades, and its application has grown considerably during the recent COVID-19 pandemic. Potential benefits of non-physical consultation extend not only to patients but also healthcare providers and healthcare systems. Next to telephone consultation (TC), the use of video consultation (VC) is increasingly popular, however, currently still more expensive and technically challenging. This study aimed to compare VC with TC for preoperative anesthesia consultations with regard to perceived quality of care and patient satisfaction. We hypothesized that VC would be superior to TC regarding quality of care and overall patient satisfaction.

Methods A prospective observational survey study was performed in the Amsterdam University Medical Center, an urban tertiary-care teaching hospital with two locations in The Netherlands. Adult patients were allocated to either the VC or TC group for their preoperative consultation. Patient satisfaction, perceived technical quality and efficiency were measured using the adapted PAT-VC questionnaire filled in by patients. Exclusion criteria included the need of a face-to-face (F2F) pre-assessment, insufficient command of the Dutch language and patient inability to perform a VC.

Results 117 patients were included, of which 54 received a TC and 63 a VC. In the VC group, patients were younger compared to TC patients, no other demographic differences were found. Patients allocated to VC had used healthcare-related VC previously more often than TC patients (38.1% vs. 17.3%, p = 0.014). Patient satisfaction was high and did not differ between groups. Median patient satisfaction grades on a scale from 1 (worst) to 10 (best) for TC and VC groups were 9 and 8, respectively (p = 0.340). VC more frequently started later than scheduled when compared to TC (30.2% vs. 18.9%, p = 0.0283). Overall, 90.6% of TC patients and 95.2% of VC patients would use the same modality again (p = 0.563).

Conclusions Based on questionnaires pertaining to patient preference and perceived quality of care, no statistical significant differences were found between VC and TC.

Note:
Funding declaration: Funding was provided by the Amsterdam University Medical Center, no additional grants were received or used.

Conflict of Interests: All authors declare no competing interests.

Ethical Approval: Ethics approval was acquired through the medical-ethical committee of the Amsterdam University Medical Center, registration number: W20_362#20.402. Informed consent was obtained from each included patient.

Keywords: telemedicine, teleconsultation, preoperative consult, anesthesia, outpatient, video consultation, telephone consultation