The Association Between Patient Satisfaction and Mode of Visit (Telemedicine Versus In-Person) in a Large Orthopaedic Practice During the COVID-19 Pandemic Lockdown: A Retrospective Study.

Abstract

During the novel coronavirus disease 2019 (COVID-19) pandemic, telemedicine was rapidly adopted to provide continued, efficient, and safe medical care. Little is known about patient satisfaction with telemedicine in orthopedics or the factors associated with selection of telemedicine versus face-to-face care. Thus, we examined (1) the association between patient satisfaction and mode of visit (telemedicine versus in-person) and (2) predictors of patient satisfaction in a large orthopedic practice during the onset of the pandemic. We conducted a retrospective cohort study of in-person and telemedicine visits within a large, university-affiliated orthopaedic practice between March 2020 and April 2020 during the onset of the COVID-19 pandemic. Patients who completed a patient satisfaction survey were included. Demographic and other office visit (eg, type of provider and type of visit) data were collected. A Patient Satisfaction Aggregate (PSA, range 0 to 1) score was calculated by taking the average of five patient satisfaction questions. Linear regression was used to examine (1) the association between PSA score and mode of visit and (2) predictors of PSA score. A total of 2,049 of 6,515 patient satisfaction surveys were completed and included for analysis, of which 748 had telemedicine visits and 1,301 had in-person visits. No association was found between PSA score and mode of visit with and without adjustment for duration of patient-physician relationship, appointment type (new versus follow-up), provider type (physician versus nonphysician), and provider subspecialty (βunadjusted = 0.004 [SE = 0.01], P = 0.44; βadjusted = 0.001 [SE = 0.01], P = 0.92). Predictors of increased PSA score were White race (P = 0.001), >1 year relationship with provider (P1-3 years = 0.01, P3-5 years = 0.04, and P5+ years = 0.002), physician provider (P = 0.004), and foot/ankle provider (P = 0.04), whereas predictors of decreased PSA score were oncology provider (P = 0.02) and spine provider (P = 0.001). We found no association between PSA score and mode of visit. Predictors of PSA score included race, duration of patient-physician relationship, provider type, and provider subspecialty.