Trends, Influence Factors, and Doctor-Patient Perspectives of Web-Based Visits for Thyroid Surgery Clinical Care: Cross-Sectional Study (Preprint)

Abstract

In recent years, the new generation of telecommunication technologies has profoundly changed the traditional medical industry. To alleviate the medical difficulties faced by patients with thyroid diseases, hospitals have opened web-based visits and actively combined online-to-offline outpatient services.

This study aims to explore differences between office and web-based outpatient services from doctors’ and patients’ perspectives, illustrate the effect of the COVID-19 pandemic on outpatient services, and provide clues for improving the online-to-offline mode of care for patients with thyroid diseases.

We collected the complete web-based and office outpatient records of the Thyroid Surgery Center of West China Hospital. A total of 300,884 completed patient encounters occurred (201,840 office visits and 99,044 web-based visits) from January 1, 2019, to May 31, 2022. We performed logistic regression to evaluate the association between the chosen visit type and patients’ sociodemographic characteristics.

The number of web-based visits rapidly increased since March 2020 and reached 45.1% (4752/10,531) of all encounters in December 2021. The COVID-19 pandemic dramatically accelerated the development of web-based visits. Web-based visits were preferred by patients 18-45 years old (odds ratio [OR] 2.043, 95% CI 1.635-2.552, <i>P</i>&lt;.001), patients with relatively high-paying jobs (technical staff: OR 1.278, 95% CI 1.088-1.479, <i>P</i>=.003; office clerk: OR 1.25, 95% CI 1.07-1.461, <i>P</i>=.005; national public servant: OR:1.248, 95% CI 1.042-1.494, <i>P</i>=.02), and patients living in Sichuan Province (excluding Chengdu; OR 1.167, 95% CI 1.107-1.23, <i>P</i>&lt;.001). The medicine cost (<i>P</i>&lt;.001) and examination cost (<i>P</i>&lt;.001) of office visits were significantly higher than those of web-based visits.

Web-based outpatient visits have increased rapidly in recent years, and the COVID-19 pandemic has boosted their development. The preference for web-based visits was influenced by the socioeconomic and demographic characteristics of both patients and doctors.