What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?

Müsellim, Benan; Börekçi, Şermin; Uzan, Gulfidan; Sak, Zafer Hasan Ali; Özdemir, Seçil Kepil; Altınışık, Göksel; Altunbey, Sinem Agca; Şen, Nazan; Kılınç, Oğuz; Yorgancıoğlu, Arzu

doi:10.4103/atm.atm_396_16

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…The workload was particularly higher in state hospitals. A recent study by Musellim et al, 18 however, suggested that in pulmonary practice, the average time allocated to each patient should be 20 minutes and that physicians should spare 25 minutes for patients with chronic lung disorders. In reality, however, under time constraints for each patient, physicians appear to depend more heavily on their clinical experience and possibly use preconceived templates in the evaluation and management of COPD patients.…”

Section: Discussionmentioning

confidence: 99%

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

Kılınç

Konya

Akgün

et al. 2018

COPD

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PurposeCOPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice.Patients and methodsFifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions.ResultsAccording to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =−0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]).ConclusionManagement of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions.

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Section: Discussionmentioning

confidence: 99%

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

Kılınç

Konya

Akgün

et al. 2018

COPD

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“…The collection of medical history has been addressed as the longest part of the medical evaluation, with a mean duration of 5-36.6 minutes. 16 The median duration of the initial VCC in the recent study was 16 (12–21) minutes. As the diagnostic spectrum in general pulmonology practice is quite broad, the needed time may be longer than that of a recent study.…”

Section: Discussionmentioning

confidence: 98%

A Retrospective Assessment of the Continuous Health Care Provided to COVID-19 Patients Consulted Via Videoconference

Bostan¹,

Çetin²,

Altınışık³

2023

Thorac Res Pract

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Objective: Telemedicine has been defined as a valuable tool in delivering care for COVID-19 patients. However, clinicians and policymakers should be convinced that traditional and new technological methods of clinical management may be equally effective. The purpose of this study was to generate some initial recommendations based on the clinical utility of videoconference consultation in forward triage and follow-up for COVID-19 patients. Material and Methods: This retrospective cross-sectional study evaluated the medical records of 100 COVID-19 patients consulted using a videoconference program (Skype), from September 1, 2020, to February 3, 2021. The data were analyzed on demographic characteristics, disease history, the need for physical examination after videoconference consultation, pre-diagnostics and diagnostics, treatment decisions, number of videoconference consultation sessions in follow-up, duration of sessions, and final outcome. Results: The male COVID-19 patients constituted 54% of the total sample. The median age was 51 (42-61) years. The median duration of the initial videoconference consultation session was 16 (12-21) minutes. Following the initial videoconference consultation session, 14 patients required follow-up with all face-to-face visits; the remaining patients were primarily followed with videoconference consultation sessions. For 25 patients, it was sufficient to provide only videoconference consultation sessions; they were not required to be in the hospital for physical examination or any subsequent investigation at all. A total of 14 patients were hospitalized. There was no statistically significant difference between the high-risk group and the other patients according to the components of the disease management process via videoconference consultation. Conclusion: Videoconference consultation enables a holistic assessment regardless of the patient's characteristics and allows for more time to be spent on each patient, particularly during the pandemic period without risk of contagion. It can be used as a forward triage and follow-up tool to identify patients in need of emergency hospitalization and continuous health care.

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“…The steady growth in the Turkish population puts ever-increasing strain on its limited budget health. In a recent work from Turkey, it was reported that the hospitals run by the Ministry of Health in Turkey allocate doctor appointments for every 7.5 min underlying the strain on the system, providers, and patients [7]. As such, Turkey’s population density will guide policy makers toward more innovative care models (Fig.…”

Section: Introductionmentioning

confidence: 99%

The role of telemedicine towards improved sustainability in health care and societal productivity in Turkey

Özen,

Kaynar,

Korkut

et al. 2024

Preprint

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The COVID-19 pandemic increased utilization of telemedicine for diagnosis and treatment. While telemedicine is not the panacea for the increasing health care burden, it can alleviate the problem. Here, the hypothetical impact of delivering telehealth care to patients in a busy tertiary cardio-vascular clinic in Istanbul, Turkey, is examined. Additionally, the potential environmental and societal ramifications of telemedicine are also examined. Demographics, health care costs, wages, productivity, and patient-specific data were exploited to develop a hypothetical telemedicine framework for the Turkish health care landscape. Specifically, the distance traveled and travel time to receive care using real-life location of the clinics and patients addresses seeking care are tabulated. Data from August 3, 2015 to January 25, 2023 resulted in 45,602 unique encounters with 448 unique diagnoses recorded for the patient encounters. The patients in the top 5% of the most common diagnoses traveled 23.82 +/- 96.3 km to reach the clinics. Based on our model and the related literature that telehealth care for chronic diseases is not inferior to face-to-face care, 656,258 km would have been saved if all patients were to take the first visit in person followed by telemedicine visits. The travel-associated carbon footprint and wage losses for in-person care in lieu of telehealth appointments is calculated and it was observed that exploiting telemedicine could have saved approximately 30% carbon footprint and prevented approximately $878,000 wage loss. As a result, it is found that application of telemedicine could ease the burden on patients, environment, increase access, and prevent the wage losses caused by unnecessary hospital visits.

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What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?

Cited by 9 publications

References 12 publications

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

A Retrospective Assessment of the Continuous Health Care Provided to COVID-19 Patients Consulted Via Videoconference

The role of telemedicine towards improved sustainability in health care and societal productivity in Turkey

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What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?

Cited by 9 publications

References 12 publications

A case scenario study for the assessment of physician&rsquo;s behavior in the management of COPD: the WHY study

A case scenario study for the assessment of physician&rsquo;s behavior in the management of COPD: the WHY study

A Retrospective Assessment of the Continuous Health Care Provided to COVID-19 Patients Consulted Via Videoconference

The role of telemedicine towards improved sustainability in health care and societal productivity in Turkey

Contact Info

Product

Resources

About

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study