Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care

Objectives: Telemedicine has been rapidly implemented in orthopedics during the coronavirus (COVID-19) pandemic. The purpose of this study was to quantify opportunity costs for patients attending typical in-person appointments and understand their perceptions of telemedicine for follow-up care. Methods: A cross-sectional study was performed by surveying patients who had elective orthopedic surgery and attended at least one in-person and one phone call appointment. The survey assessed opportunity costs associated with in-person appointments, experience with telemedicine, and preferred type of future appointment. Results: Of the 49 eligible patients, 41 (83.7%) completed the survey. The median travel distance to the clinic was 108 km, and the time spent in the clinic was 60 min. Participants responded “yes” to various forms of opportunity costs associated with attending in-person appointments, including missed work (46.3%), lost income (34.1%), recreational activities (26.8%), home or yard care (14.6%), socializing with friends or family (12.2%), school (2.4%), and childcare (2.4%). In addition, elements of the telemedicine appointment were rated from 1 (least favorable) to 10 (most favorable), and averages were calculated for ease of use (9.2), convenience (8.4), confidence in the doctor’s diagnostic ability (8.2), likelihood of using the service again (6.4), and overall satisfaction (8.2). Preferred future appointment types included having the first visit in-person and subsequent visits via telephone (61.0%), in-person only (36.6%), and unsure (2.4%). Conclusion: This study identifies various opportunity costs associated with in-person orthopedic appointments and a favorable view toward telemedicine for follow-up care.

Getting Help With Housework

Research on household labor typically has focused on housework performed by spouses, occasionally including children and other household members. Help from outsiders has been studied separately in research on kin networks or paid help. The author investigate conditions under which households receive outside formal or informal help using data for a probability sample of middle-aged and older persons living in a variety of household types. Most housework is performed by household members; outside help with cleaning, yard care, and/or household repair is most common. Households are most likely to accomplish housework internally when they include married couples and more adult members and members of both sexes, there are fewer children, housing is owner occupied, and members are younger and healthier. Higher income increases formal help, whereas local adult children increase informal help. Involvement in other kin, friendship, or neighborhood networks does not influence patterns of housework help.

INFO-U FAXBACK: DELIVERING CONSUMER INFORMATION WITH FAX-ON-DEMAND TECHNOLOGY

Consumers applaud the Minnesota Extension Service, INFO-U FAXBACK system that delivers consumer horticulture publications 24 hours a day, 7 days a week. Consumers call the fax-on-demand system and, following voice instructions, use the phone key pad to enter their fax number and select a publication or a catalog of over 300 yard care and gardening titles. Documents selected are transmitted immediately to the fax number entered. Delivery cost runs $0.18 per document in the metro toll-free calling area, and $1.64 for long-distance calls. Compared to $2.75 for printing, postage, and handling per fact sheet sent by mail, the system saved $7000 in 1995 transmitting 2722 publications. Investment in system hardware and software runs $6000 to $8000. Documents can be stored as DOS text, which eliminates artwork and formatting, or scanned as graphic files that require 40 times more hard drive storage space. A document requires a one-time investment in staff time of 10–60 minutes to reformat for the fax-on-demand protocol.