K. Harris1, E. C. Hamilton1, A. C. Fonseca1, S. Mahajan1, A. A. Eguia1, M. T. Harting1, K. Tsao1, M. T. Austin1 1McGovern Medical School At The University Of Texas Health Science Center At Houston,Department Of Pediatric Surgery,Houston, TEXAS, USA
Introduction: Telemedicine has the potential to decrease the burden of postoperative outpatient care for families of pediatric surgical patients. The purpose of this study was to determine travel and work-related costs related to pediatric surgical clinic visits and parents’ attitudes towards telemedicine.
Methods: A non-random sample of parents of patients presenting to our outpatient pediatric surgery clinic for postoperative, preoperative, and new consults were administered a previously published 29-question survey to assess the burden of attending clinic and their preferences towards telemedicine for postoperative care. Pearson chi-square test and univariate logistic regression were used for statistical analysis.
Results:Among 186 survey respondents, most were Hispanic (n=125) followed by non-Hispanic white (NHW) (n=31), non-Hispanic black (NHB) (n=14) and 16 other/unknown. Eighty-one (44%) parents traveled < 25 miles, 78 (43%) traveled between 26-50 miles, and 24 (13%) traveled > 50 miles. The majority of respondents (n=58, 33%) spent $25 to $50 on travel and additional ancillary expenses. Considering all expenses, including missed work, most parents felt that the overall cost of coming to pediatric general surgery clinic was medium (n=75, 42%). Regarding telemedicine in the form of video conferencing for postoperative care, most parents were comfortable using telemedicine to discuss general questions that arose (n=122, 75%) and for routine follow-up (n=94, 56%). Fewer parents were comfortable with the use of telemedicine to assess acute problems (n=72, 45%). Comfort in using telemedicine for postoperative care was not associated with perceived total costs, distance traveled, education level, income level, race, or age. The strongest predictor for comfort in using telemedicine for postoperative care was being comfortable communicating by email and/or telemedicine to discuss medical issues(Table 1). Spanish-only speaking parents were significantly more likely than English speaking parents to be comfortable using telemedicine for routine postoperative follow-up (OR 2.17; 95% CI 1.01-4.61). There was no significant difference between Spanish-only speaking parents and English-speaking parents when assessing comfort with using telemedicine for acute problems (OR 1.7; 95% CI 0.79-3.65) or general questions (OR 0.88; 95% CI 0.38-2.02).
Conclusion:Clinic visits result in significant costs for parents of pediatric surgical patients. Overall, comfort in using communication technologies was the strongest predictor for comfort using telemedicine for postoperative care. Spanish-only speaking parents were more likely to be comfortable using telemedicine for routine postoperative follow-up as compared to English-speaking parents.
