Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey

Background Telepsychiatry enables patients to establish or maintain psychiatric care during the COVID-19 pandemic. Little is known about the factors influencing patients’ initial decisions to participate in telepsychiatry in the midst of a public health crisis. Objective This paper seeks to examine factors influencing patients’ initial decisions to accept or decline telepsychiatry immediately after the stay-at-home order in Michigan, their initial choice of virtual care modality (video or telephone), and their anticipated participation in telepsychiatry once clinics reopen for in-person visits. Methods Between June and August 2020, we conducted a telephone-based survey using a questionnaire comprising 14 quantitative and two qualitative items as part of a quality improvement initiative. We targeted patients who had an in-person appointment date that fell in the first few weeks following the Michigan governor’s stay-at-home order, necessitating conversion to virtual visits or deferment of in-person care. We used descriptive statistics to report individual survey responses and assess the association between chosen visit type and patient characteristics and future participation in telepsychiatry using multivariable logistic regression. Results A total of 244 patients whose original in-person appointments were scheduled within the first 3 weeks of the stay-at-home order in Michigan completed the telephone survey. The majority of the 244 respondents (n=202, 82.8%) initially chose to receive psychiatric care through video visits, while 13.5% (n=33) chose telephone visits and 1.2% (n=3) decided to postpone care until in-person visit availability. Patient age correlated with chosen visit type (P<.001; 95% CI 0.02-0.06). Patients aged ≥44 years were more likely than patients aged 0-44 years to opt for telephone visits (relative risk reduction [RRR] 1.2; 95% CI 1.06-1.35). Patient sex (P=.99), race (P=.06), type of insurance (P=.08), and number of previous visits to the clinic (P=.63) were not statistically relevant. Approximately half of the respondents (114/244, 46.7%) stated they were likely to continue with telepsychiatry even after in-person visits were made available. Telephone visit users were less likely than video visit users to anticipate future participation in telepsychiatry (RRR 1.08; 95% CI 0.97-1.2). Overall, virtual visits met or exceeded expectations for the majority of users. Conclusions In this cohort, patient age correlates with the choice of virtual visit type, with older adults more likely to choose telephone visits over video visits. Understanding challenges to patient-facing technologies can help advance health equity and guide best practices for engaging patients and families through telehealth.

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Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey (Preprint)

10.2196/preprints.25469 ◽

2020 ◽

Author(s):

Jennifer Severe ◽

Ruiqi Tang ◽

Faith Horbatch ◽

Regina Onishchenko ◽

Vidisha Naini ◽

...

Keyword(s):

Psychiatric Care ◽

Patient Characteristics ◽

Quality Improvement Initiative ◽

Patient Age ◽

Health Crisis ◽

Factors Influencing ◽

Patient Âgé ◽

Virtual Visits ◽

Survey Responses ◽

At Home

BACKGROUND Telepsychiatry enables patients to establish or maintain psychiatric care during the COVID-19 pandemic. Little is known about the factors influencing patients’ initial decisions to participate in telepsychiatry in the midst of a public health crisis. OBJECTIVE This paper seeks to examine factors influencing patients’ initial decisions to accept or decline telepsychiatry immediately after the stay-at-home order in Michigan, their initial choice of virtual care modality (video or telephone), and their anticipated participation in telepsychiatry once clinics reopen for in-person visits. METHODS Between June and August 2020, we conducted a telephone-based survey using a questionnaire comprising 14 quantitative and two qualitative items as part of a quality improvement initiative. We targeted patients who had an in-person appointment date that fell in the first few weeks following the Michigan governor’s stay-at-home order, necessitating conversion to virtual visits or deferment of in-person care. We used descriptive statistics to report individual survey responses and assess the association between chosen visit type and patient characteristics and future participation in telepsychiatry using multivariable logistic regression. RESULTS A total of 244 patients whose original in-person appointments were scheduled within the first 3 weeks of the stay-at-home order in Michigan completed the telephone survey. The majority of the 244 respondents (n=202, 82.8%) initially chose to receive psychiatric care through video visits, while 13.5% (n=33) chose telephone visits and 1.2% (n=3) decided to postpone care until in-person visit availability. Patient age correlated with chosen visit type (P<.001; 95% CI 0.02-0.06). Patients aged ≥44 years were more likely than patients aged 0-44 years to opt for telephone visits (relative risk reduction [RRR] 1.2; 95% CI 1.06-1.35). Patient sex (P=.99), race (P=.06), type of insurance (P=.08), and number of previous visits to the clinic (P=.63) were not statistically relevant. Approximately half of the respondents (114/244, 46.7%) stated they were likely to continue with telepsychiatry even after in-person visits were made available. Telephone visit users were less likely than video visit users to anticipate future participation in telepsychiatry (RRR 1.08; 95% CI 0.97-1.2). Overall, virtual visits met or exceeded expectations for the majority of users. CONCLUSIONS In this cohort, patient age correlates with the choice of virtual visit type, with older adults more likely to choose telephone visits over video visits. Understanding challenges to patient-facing technologies can help advance health equity and guide best practices for engaging patients and families through telehealth.

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Correction: Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey (Preprint)

10.2196/preprints.27357 ◽

2021 ◽

Author(s):

Jennifer Severe ◽

Ruiqi Tang ◽

Faith Horbatch ◽

Regina Onishchenko ◽

Vidisha Naini ◽

...

Keyword(s):

Psychiatric Care ◽

Patient Characteristics ◽

Quality Improvement Initiative ◽

Patient Age ◽

Health Crisis ◽

Factors Influencing ◽

Patient Âgé ◽

Virtual Visits ◽

Survey Responses ◽

At Home

UNSTRUCTURED Telepsychiatry enables patients to establish or maintain psychiatric care during the COVID-19 pandemic. Little is known about the factors influencing patients’ initial decisions to participate in telepsychiatry in the midst of a public health crisis. This paper seeks to examine factors influencing patients’ initial decisions to accept or decline telepsychiatry immediately after the stay-at-home order in Michigan, their initial choice of virtual care modality (video or telephone), and their anticipated participation in telepsychiatry once clinics reopen for in-person visits. Between June and August 2020, we conducted a telephone-based survey using a questionnaire comprising 14 quantitative and two qualitative items as part of a quality improvement initiative. We targeted patients who had an in-person appointment date that fell in the first few weeks following the Michigan governor’s stay-at-home order, necessitating conversion to virtual visits or deferment of in-person care. We used descriptive statistics to report individual survey responses and assess the association between chosen visit type and patient characteristics and future participation in telepsychiatry using multivariable logistic regression. A total of 244 patients whose original in-person appointments were scheduled within the first 3 weeks of the stay-at-home order in Michigan completed the telephone survey. The majority of the 244 respondents (n=202, 82.8%) initially chose to receive psychiatric care through video visits, while 13.5% (n=33) chose telephone visits and 1.2% (n=3) decided to postpone care until in-person visit availability. Patient age correlated with chosen visit type (P<.001; 95% CI 0.02-0.06). Patients aged ≥44 years were more likely than patients aged 0-44 years to opt for telephone visits (relative risk reduction [RRR] 1.2; 95% CI 1.06-1.35). Patient sex (P=.99), race (P=.06), type of insurance (P=.08), and number of previous visits to the clinic (P=.63) were not statistically relevant. Half of the respondents (132/244, 54.1%) stated they were likely to continue with telepsychiatry even after in-person visits were made available. Telephone visit users were less likely than video visit users to anticipate future participation in telepsychiatry (RRR 1.08; 95% CI 0.97-1.2). Overall, virtual visits met or exceeded expectations for the majority of users. In this cohort, patient age correlates with the choice of virtual visit type, with older adults more likely to choose telephone visits over video visits. Understanding challenges to patient-facing technologies can help advance health equity and guide best practices for engaging patients and families through telehealth.

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The impact of patient age and comorbidities on the occurrence of “never events” in cerebrovascular surgery: an analysis of the Nationwide Inpatient Sample

Journal of Neurosurgery ◽

10.3171/2014.4.jns131253 ◽

2014 ◽

Vol 121 (3) ◽

pp. 580-586 ◽

Cited By ~ 22

Author(s):

Timothy Wen ◽

Shuhan He ◽

Frank Attenello ◽

Steven Y. Cen ◽

May Kim-Tenser ◽

...

Keyword(s):

Hospital Costs ◽

Patient Characteristics ◽

High Risk Population ◽

Health Care Administrators ◽

Patient Age ◽

Medical Comorbidities ◽

Patient Âgé ◽

Never Events ◽

Tract Infections ◽

The Impact

Object As health care administrators focus on patient safety and cost-effectiveness, methodical assessment of quality outcome measures is critical. In 2008 the Centers for Medicare and Medicaid Services (CMS) published a series of “never events” that included 11 hospital-acquired conditions (HACs) for which related costs of treatment are not reimbursed. Cerebrovascular procedures (CVPs) are complex and are often performed in patients with significant medical comorbidities. Methods This study examines the impact of patient age and medical comorbidities on the occurrence of CMS-defined HACs, as well as the effect of these factors on the length of stay (LOS) and hospitalization charges in patients undergoing common CVPs. Results The HACs occurred at a frequency of 0.49% (1.33% in the intracranial procedures and 0.33% in the carotid procedures). Falls/trauma (n = 4610, 72.3% HACs, 357 HACs per 100,000 CVPs) and catheter-associated urinary tract infections (n = 714, 11.2% HACs, 55 HACs per 100,000 CVPs) were the most common events. Age and the presence of ≥ 2 comorbidities were strong independent predictors of HACs (p < 0.0001). The occurrence of HACs negatively impacts both LOS and hospital costs. Patients with at least 1 HAC were 10 times more likely to have prolonged LOS (≥ 90th percentile) (p < 0.0001), and 8 times more likely to have high inpatient costs (≥ 90th percentile) (p < 0.0001) when adjusting for patient and hospital factors. Conclusions Improved quality protocols focused on individual patient characteristics might help to decrease the frequency of HACs in this high-risk population. These data suggest that risk adjustment according to underlying patient factors may be warranted when considering reimbursement for costs related to HACs in the setting of CVPs.

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Abstract 260: Associations of Chest Compression Release Velocity and Age, Weight, and Gender During Cardiac Resuscitation

Circulation ◽

10.1161/circ.138.suppl_2.260 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

John H Sutter ◽

Samuel Beger ◽

Chengcheng Hu ◽

Daniel W Spaite ◽

Annemarie Silver ◽

...

Keyword(s):

Chest Compression ◽

Patient Characteristics ◽

Ohca Patient ◽

Patient Age ◽

Patient Âgé ◽

Younger Age ◽

Wall Compliance ◽

Male Patients ◽

And Gender ◽

Weight Table

Background: Higher chest compression release velocity (CCRV) is associated with better outcomes after OHCA. Patient age and gender have been associated with variations in chest wall compliance and compressibility which may impact outcomes. Hypothesis: To evaluate the association between CCRV and OHCA patient age, weight, and gender. Methods: Observational study of prospectively collected OHCA quality improvement data in two suburban EMS agencies in Arizona between 10/1/2008 and 12/31/2016. Patient age and weight were categorized into quartiles for the analysis. CCRV was summarized at each level of the categorical variable by median and inter-quartile range (IQR), and was then compared between different levels by the Kruskal-Wallis test. Results: During the study period, 2,661 OHCA cases were treated. After exclusion criteria, 1,140 cases remained for analysis. Median duration of compressions was 8.70 minutes. Mean CCRV was negatively correlated with age and positively correlated with weight (Table). Male patients exhibited a greater mean CCRV compared to female patients [344.4 mm/s (IQR 307.3-384.6) vs. 331.5 (285.3-385.5), p=0.0133]. Conclusion: Patient characteristics including younger age, male gender, and increased weight were associated with a higher CCRV during OHCA resuscitation.

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Increasing Age Is Not Independently Associated with Increased 30-Day Morbidity after Hip Arthroscopy

The Journal of Hip Surgery ◽

10.1055/s-0038-1673374 ◽

2018 ◽

Vol 02 (03) ◽

pp. 148-154

Author(s):

Venkat Boddapati ◽

Jamie Confino ◽

Michael Fu ◽

Kyle Duchman ◽

Robert Westermann ◽

...

Keyword(s):

Multivariate Analysis ◽

Postoperative Complications ◽

Hip Arthroscopy ◽

Older Patients ◽

Patient Characteristics ◽

Adverse Outcomes ◽

Improvement Program ◽

Patient Age ◽

Age Cohorts ◽

Patient Âgé

AbstractThe purpose of this study is to examine the 30-day postoperative complications after hip arthroscopy as a function of patient age. The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2016 was used to identify all patients undergoing hip arthroscopy using Current Procedural Terminology and International Classification of Disease codes. Patient characteristics and postoperative complications were compared in a retrospective cohort study with a level of evidence 3 across patient age cohorts using bivariate and multivariate analysis that corrected for differences in baseline patient characteristics. In total, 2,427 patients undergoing hip arthroscopy were identified. Of all identified patients, 667 (27.5%) were under 30 years of age, 596 (24.5%) were between 31 and 40, 599 (24.6%) were between 41 and 50, and 566 (23.3%) were older than 50. Chondroplasty, abrasion arthroplasty, and/or resection of the labrum were the most commonly performed procedures in all age groups. As age increased, patients were more likely to be female and have a higher body mass index, more medical comorbidities, a shorter operative duration, and a higher American Society of Anesthesiologists class. The rate of any 30-day postoperative complication was 1.35% in patients under 30 years of age, 1.68% in patients between 31 and 40, 2.67% in patients between 41 and 50, and 5.12% in patients older than 50 (p < 0.001). Older patients also had a higher rate of deep surgical site infections and blood transfusions (p ≤ 0.001). However, no differences were identified with multivariate analysis. While older patients had higher short-term complications following hip arthroscopy, age alone was not an independent predictor of adverse outcomes. Further investigation is necessary to determine the risk factors associated with significant postoperative morbidity in older patients undergoing hip arthroscopy.

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Predictors of Hand Dexterity after Single-Digit Replantation

Journal of Reconstructive Microsurgery ◽

10.1055/s-0038-1669446 ◽

2018 ◽

Vol 35 (03) ◽

pp. 194-197 ◽

Cited By ~ 3

Author(s):

Kenji Kawamura ◽

Shohei Omokawa ◽

Takamasa Shimizu ◽

Akio Iida ◽

Yasuhito Tanaka ◽

...

Keyword(s):

Motor Skill ◽

Outcome Variable ◽

Pinch Strength ◽

Single Digit ◽

Patient Age ◽

Active Motion ◽

Factors Influencing ◽

Hand Dexterity ◽

Patient Âgé

Background Microsurgical replantation of the thumb and digits has become an increasingly familiar technique in clinical practice worldwide. However, successful digit replantation does not always provide better hand function than revision amputation. Little information is available regarding predictors of motor skill activities of replanted hands. Therefore, we retrospectively evaluated hand dexterity after single-digit replantation at a minimum follow-up of 1 year and analyzed the factors influencing dexterity. Methods This retrospective cohort study included 23 patients treated for amputation injuries at our institution from 2014 to 2015. Patients with amputations from Tamai's zone 2 to 5 of the thumb (3 patients), index finger (11 patients), or middle finger (9 patients) who underwent digital replantation surgery and were followed up for more than 1 year were included. Follow-up evaluations were conducted at an average of 23 months postoperatively (range: 13–25 months). We hypothesized that possible factors influencing hand dexterity after single-digit replantation were patient age, injured finger, key pinch strength, Semmes–Weinstein test result, and percentage of total active motion. Relationships between the outcome variable, which was the result of the Purdue Pegboard Test of hand dexterity, and explanatory variables were analyzed using Spearman's correlation coefficient. A p-value of < 0.05 indicated statistical significance. Results No postoperative complications occurred. Univariate analysis indicated that decreased hand dexterity after single-digit replantation was significantly associated with older age (p = 0.001) and poor recovery of sensation, as shown by the Semmes–Weinstein test (p = 0.012). Conclusion Patient age was a risk factor for low hand dexterity after replantation surgery. Recovery of finger sensitivity enhanced dexterity of motor skill activities following finger replantation surgery.

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The impact of patient characteristics on voiding symptoms, irritative symptoms, and sexual function, following stereotactic body radiotherapy for prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.7_suppl.245 ◽

2015 ◽

Vol 33 (7_suppl) ◽

pp. 245-245

Author(s):

Zaker Hamid Rana ◽

Robert Hong ◽

Donald McRae ◽

Gregory Bernstein ◽

Robert Mordkin ◽

...

Keyword(s):

Sexual Dysfunction ◽

Sexual Function ◽

Stereotactic Body Radiotherapy ◽

Patient Characteristics ◽

Patient Age ◽

Prostate Radiotherapy ◽

Voiding Symptoms ◽

Patient Âgé ◽

Prostate Size ◽

The Impact

245 Background: Urinary symptoms and sexual dysfunction are the two most common complaints following prostate radiotherapy. There is limited clinical data evaluating the impact of baseline patient characteristics on response to hypofractionated treatment. This study sought to evaluate how patient age and prostate size affects voiding symptoms, irritative symptoms, and sexual function, following stereotactic body radiotherapy (SBRT). Methods: This retrospective analysis includes 102 non-metastatic patients treated with SBRT at a single institution between May 2008 and September 2014. The course of radiotherapy consisted of 36.25 Gy (range 35–40) over 5 daily fractions. International Prostate Symptom Score (IPSS) and Sexual Health Inventory for Men (SHIM) were recorded at baseline, 1, 3, 6, 9, 12, 18, 24, and 36 months after treatment. Results: Median patient age was 68 years old (range 47-88) and median prostate volume was 43 cc (range 18.7-170.7). Baseline IPSS irritative score, IPSS voiding score, and SHIM score were 5.34, 5.42, and 13.55. A statistically significant increase in voiding (7.02), irritative (7.21), and decrease in SHIM score (11.77) was observed after one month (p < .05). The IPSS irritative score and IPSS voiding scores returned to baseline in >90% of patients by 9 months and SHIM scores returned to baseline in >90% of patients by 2 years. Prostate size ≤ 50 cc showed higher baseline IPSS voiding and irritative resolution rates after 3 months (p < .05). Conclusions: While an increase in IPSS irritative score, and a decrease in SHIM score initially occurred, all symptoms return to baseline within three years. Age did not affect urinary or sexual dysfunction following radiotherapy. Patients with smaller prostate volumes had significantly better voiding and irritative outcomes when compared to larger volumes.

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Factors Influencing Clinical and MRI Outcomes of Mesenchymal Stem Cell Implantation With Concomitant High Tibial Osteotomy for Varus Knee Osteoarthritis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120979987 ◽

2021 ◽

Vol 9 (2) ◽

pp. 232596712097998

Author(s):

Yong Sang Kim ◽

Dong Suk Suh ◽

Dae Hyun Tak ◽

Pill Ku Chung ◽

Yoo Beom Kwon ◽

...

Keyword(s):

Knee Osteoarthritis ◽

High Tibial Osteotomy ◽

Cartilage Regeneration ◽

Tibial Osteotomy ◽

Varus Knee ◽

Patient Age ◽

Knee Oa ◽

Radiographic Outcomes ◽

Factors Influencing ◽

Patient Âgé

Background:Cartilage repair procedures using mesenchymal stem cells (MSCs) can provide superior cartilage regeneration in the medial compartment of the knee joint when high tibial osteotomy (HTO) is performed for varus knee osteoarthritis (OA). However, few studies have reported the factors influencing the outcomes of MSC implantation with concomitant HTO.Purpose:To investigate the outcomes of MSC implantation with concomitant HTO and to identify the prognostic factors that are associated with the outcomes.Study Design:Case series; Level of evidence, 4.Methods:A total of 71 patients (75 knees) were retrospectively evaluated after MSC implantation with concomitant HTO. Clinical and radiological outcomes were evaluated, and magnetic resonance imaging (MRI) was used to assess cartilage regeneration. Statistical analyses were performed to determine the effect of different factors on clinical, radiographic, and MRI outcomes.Results:Clinical and radiographic outcomes improved significantly from preoperatively to final follow-up ( P < .001 for all), and overall cartilage regeneration was encouraging. Significant correlations were found between clinical and MRI outcomes. However, radiographic outcomes were not significantly correlated with clinical or MRI outcomes. Patient age and number of MSCs showed significant correlations with clinical and MRI outcomes. On multivariate analyses, patient age and number of MSCs showed high prognostic significance with poor clinical outcomes.Conclusion:MSC implantation with concomitant HTO provided feasible cartilage regeneration and satisfactory clinical outcomes for patients with varus knee OA. Patient age and number of MSCs were important factors that influenced the clinical and MRI outcomes of MSC implantation with concomitant HTO for varus knee OA.

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