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

Abstract

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.

Factors Influencing Compliance to Follow-up Visits in Orthopaedic Surgery

“…To address this, many clinics will overbook appointments to retain productivity in the setting of missed visits; however, there are increased opportunity costs to patients through prolonged queues in clinic and decreased patient satisfaction, which may further exacerbate future no-show rates. 21,22 Distance and Travel Time Distance from care is thought to have a negative effect on patient care and follow-up across many healthcare specialties. 20,23,24 Despite this, few studies have cited distance as a risk factor for orthopaedic surgery patients in not attending their follow-up appointments.…”

“…37,38 Implementation of telehealth follow-up appointments may increase patient commitment to care, but this may not be feasible in all clinics. 22 Alternatively, telemedicine visits could be offered exclusively to patients who are at a higher risk of missing a postoperative appointment. 21 Telehealth follow-up appointments would be suitable for addressing pain, wound healing, and mobility concerns.…”

Telemedicine and the environment: life cycle environmental emissions from in-person and virtual clinic visits

“…For some practice settings there will be an upfront cost to acquire equipment for telehealth as well as a period of lower efficiency while transitioning to a different model of patient visits, but there is likely to be an eventual net cost savings 32 . Traditional visits carry a large opportunity cost in terms of missed work, travel time and missed recreation for patients 33 . Based on the amount of time spent traveling and waiting to see a physician, telehealth has the potential to decrease these costs dramatically 34 .…”

Efficiency of a virtual fracture care protocol in non-operative treatment of adult patients with a distal radial fracture

“…The implementation of VFC increased remote delivery of care, which has proven to be an efficient, cost-effective and satisfactory alternative to face-to-face care (Ekeland et al., 2010; Graham et al., 2021; Haider et al., 2022; Lee et al., 2021; Thatcher et al., 2021). Other studies on VFC protocols have reported similar results (Brogan et al., 2017; Davey et al., 2020; Dunkerley et al., 2020).…”